Switch therapy of the association of ampicillin and sulbactam in a hospital complex in southern Brazil

Abstract

Objective: To identify the frequency of pharmaceutical interventions performed and accepted by the physicians and the cost savings generated by the switch therapy of the association of ampicillin and sulbactam to the association of amoxicillin and potassium clavulanate in adult patients in a hospital complex. Methods: Observational cross-sectional study, based on the assessment of adult patients in intravenous use of the association of ampicillin and sulbactam for more than three days, from April to June 2021. Sampling was done for convenience. Interventions suggesting the change to the tablet of the association of amoxicillin and potassium clavulanate were performed through standard alert and evolution in the electronic health record of eligible patients. Acceptance was verified by followup of the new prescription. If not accepted, a new intervention was performed in 48 hours. Cost savings were calculated based on the average cost of medicines and medical supplies, available on the institution’s computerized system. The collected data were analyzed using descriptive statistics. Results: A total of 322 patients were evaluable, of which 174 (54,0%) were considered eligible for the switch therapy. A total of 226 pharmaceutical interventions were performed, in which 14 (6,2%) were accepted by the physicians, generating savings of US$912,56. Conclusions: Pharmaceutical interventions recommending the switch therapy of the association of ampicillin and sulbactam had low adherence by the physicians, but, despite this, they presented a significant potential for cost savings. To obtain better results, it is necessary to promote the education of the clinical staff and improve communication between pharmacists and physicians.