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JAC Advance Access originally published online on October 9, 2006
Journal of Antimicrobial Chemotherapy 2006 58(6):1230-1237; doi:10.1093/jac/dkl405
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Antimicrobial practice

Impact of the Hospital Pharmacy Initiative for promoting prudent use of antibiotics in hospitals in England

H. J. Wickens1,* and A. Jacklin2

1 Pharmacy Department, St Mary's NHS Trust London W2 1NY, UK 2 Pharmacy Department, Hammersmith Hospitals NHS Trust, London W12 OHS, UK

Received 18 May 2006; returned 7 June 2006; revised 11 September 2006; accepted 12 September 2006


*Corresponding author. Tel: +44-207-886-1078; Fax: +44-207-886-2083; E-mail: hayley.wickens{at}st-marys.nhs.uk

Objectives: In July 2003, the UK Department of Health announced an allocation of £12 million to hospital pharmacists to improve the monitoring and control of anti-infective use over the ensuing 3 year period (the Hospital Pharmacy Initiative, or HPI). Chief Pharmacists were asked to use this money for developments to promote prudent antibiotic use and monitoring of antimicrobials within their Trusts. This study aimed to evaluate the impact of the HPI funding, which at the time had been in place for nearly 2 years, on pharmacy activities in this area.

Methods: A postal questionnaire was sent to the pharmacy department of each acute hospital Trust in England, aiming to provide a descriptive overview of the activities of hospital pharmacy staff in the field of anti-infectives and to explore the extent to which these activities were made possible by the HPI funding.

Results: One hundred and forty-one specialist antimicrobial pharmacy staff were employed in 130 responding Trusts; 89% were pharmacists, 7% pharmacy technicians and the remainder administrative staff. Three-quarters of these staff had been employed due to the funding, resulting in review of antimicrobial prescribing guidelines, antibiotic audit projects and multidisciplinary work with Microbiology/Infectious Diseases staff. Thirteen Trusts gave details of drug acquisition cost savings; over the course of a year, these Trusts saved £1.1 million in total.

Conclusions: The HPI funding has facilitated greater interaction between Pharmacy and Microbiology/Infectious Diseases departments than was previously possible. Significant reductions in antibiotic acquisition costs have been demonstrated, though further work is warranted to fully establish the impact of pharmacy activities on clinical and microbiological outcomes.

Keywords: antibacterials , antibiotic pharmacist , antibiotic policy , antibiotic management , pharmacist


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