Impact of a clinical pharmacist-led stewardship programme on antibiotic utilisation and clinical outcomes in thoracic surgery: a retrospective interrupted time-series study at a tertiary hospital in China

Objectives This study aims to assess the impact of clinical pharmacist-led antimicrobial stewardship on antibiotic use and postoperative pulmonary infection in a surgical department. Design Retrospective and cross-sectional. Setting A tertiary hospital in Wuhan, China. Participants A total of 9157 patients who underwent video-assisted thoracoscopic lung surgery (VATLS) were included (4949 and 4208 pre-implementation and post-implementation). Methods An interrupted time-series design with segmented regression analysis was employed to evaluate changes in antibiotic use intensity (defined daily dose/100 bed-days), antibiotic spectrum coverage (scores/100 bed-days) and postoperative pulmonary infection rate before and after implementation of the stewardship programme. Between-group comparisons of antibiotic use rates and treatment duration were performed using χ 2 test, Fisher’s exact test, t-test or Mann-Whitney U test, as appropriate. Outcome measures Antibiotic use intensity (defined daily dose/100 bed-days), antibiotic spectrum coverage (scores/100 bed-days), postoperative pulmonary infection rates, the proportion and the duration of antibiotic use. Results Following implementation, antibiotic use intensity decreased immediately by 96.65 defined daily doses/100 bed-days (95% CI −122.56 to −70.74; p