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Objectives  To evaluate the impact and cost-benefit value of pharmacist interventions for prophylactic antibiotic use in surgical patients undergoing clean or clean-contaminated operations.    Methods  A pre-to-post intervention study was performed in the Department of Urological Surgery of a tertiary hospital. Patients admitted from January through June 2011, undergoing clean or clean-contaminated surgery, served as the pre-intervention group; patients admitted from January through June 2012 formed the post-intervention group. Pharmacist interventions were performed for the surgeries in the post-intervention group. The criteria for the rational use of antibiotic prophylaxis were established by the hospital administration. The pharmacist interventions included real-time monitoring of medical records and controlling of the prescriptions of prophylactic antibiotics against the criteria. The pre- and post-intervention groups were then compared to evaluate the outcomes of the pharmacist interventions. A cost-benefit analysis was performed to determine the economic effects of implementing the pharmacist intervention on preoperative antibiotic prophylaxis.    Results  After the pharmacist intervention, a significant decrease was found in the rate of no indications for prophylactic antibiotic use ( p  = 0.004), the rate of broad-spectrum antibiotic use ( p <0.001), the rate of drug replacement ( p <0.001) and the rate of prolonged duration of prophylaxis ( p <0.001). Significant reductions were observed in the mean antibiotic cost ( p <0.001), the mean duration of antibiotic prophylaxis ( p <0.001) and the mean number of antibiotics used ( p <0.001). A significant increase was observed in the rate of correct choice of antibiotics ( p <0.001). The ratio of the net mean cost savings for antibiotics to the mean cost of pharmacist time was approximately 18.79∶1.    Conclusion  Real-time interventions provided by a clinical pharmacist promoted rational use of prophylactic antibiotics, with a significant reduction in antibiotic costs, thus leading to favorable economic outcomes.

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Pharmacist Interventions for Prophylactic Antibiotic Use in Urological Inpatients Undergoing Clean or Clean-Contaminated Operations in a Chinese Hospital