CPS is a Member of EAHP since 1998.
Contact information
Address: Masarykova 2, 10000 Zagreb, Croatia
Tel: +385 1 48 72 849
Fax: +385 1 48 72 853
Email: hfd-fg-ap@zg.t-com.hr
Website: www.farmaceut.org
- The development of the pharmaceutical profession by encouraging professional and scientific work;
- Maintenance of continuing education courses;
- Professional and scientific conferences;
- Publishing of journals and books;
- Promoting and improving all aspects of pharmaceutical education;
- Collaborate with health care institutions, Croatian Chamber of Pharmacists and other associations;
- Respect for ethical principles;
- Developing awareness of the honour, dignity and responsibility of the pharmacy calls.
The CPS has 1,800 members and represents 77 hospital pharmacists working in the 45 hospital pharmacies within Croatia. The total number of pharmacists in Croatia is 3,500.
Since 2008 there is a legally defined hospital pharmacy specialisation which lasts 3 years (1 year theoretical and 2 years practical/clinical experience). It is not mandatory to complete this training to work as a hospital pharmacist in Croatia.
Upon completion of the program the student acquires theoretical and practical knowledge which promotes and provides proper and safe use of medicines, with a view to:
- Increase the effectiveness of treatment, using the most effective drug for the individual patient;
- Reducing the risks associated with the therapy, supervision of the prescribed doses and drug dosing intervals, prediction and prevention of any possible drug interactions and other medication errors, following the medication treatment and patient compliance;
- Reduce the cost of pharmacotherapy in line with national policy, trying to provide the best choice for most patients at the same time.
Additionally it is possible to undertake a 2 year postgraduate course in clinical pharmacy.
Publications:
- Farmaceutski glasnik (In Croatian)
- Acta Pharmaceutica – Journal HFD, in the English language. Published four times a year. It publishes original research papers, and short communications in the field of pharmacy and related disciplines, including reviews of new books.
Darija Kuruc Poje, univ.mag.pharm., clinical pharmacist (General Hospital “Dr. T. Bardek “Koprivnica)
Mr.sc. Vesna Mađarić, MD, infectologist (General Hospital “Dr. T. Bardek “Koprivnica)
Vlatka Janeš Poje, MD, microbiologist (Department of Public Health Koprivnica County)
Description:
From the 1st September 2017 at the General Hospital “Dr. Tomislav Bardek”, the project of the Antibiotic Stewardship team (A-team) implementation was initiated by infectologists, microbiologists and clinical pharmacist. The aim was rationalizing the treatment of patients with the most severe infections. The A-team goal is to optimize clinical outcomes by minimizing adverse effects of antibiotics, increasing susceptibility to targeted antibiotics and reducing costs. In recent years, there has been an increase in the consumption of antibiotics used as the last line of treatment when other antibiotics no longer work (the so-called antibiotic reserve, AR), which is why we started with the pilot project at our institution. The pilot proved to be extremely successful, which was the reason of presenting the results of the project to the Ministry of Health and all the heads of county and general hospitals on 25th of April 2018. Our hospital, also organized a professional meeting on 15th of June 2018 for all clinics, county, general and special hospitals, i.e. directors and their future A-teams, where, with distinguished guest lecturers (from the University Hospital Centre Zagreb, the University Hospital for Infectious Disease Dr. Fran Mihaljević, Zagreb and the Faculty of Pharmacy and Biochemistry, University of Zagreb), we shared our experiences and ways of implementation in hospitals.
BACKGROUND:
Antimicrobial resistance poses an increasing problem by endangering the health and safety of patients in all health environments. It is estimated that by 2050 mortality from antimicrobial resistance will amount to 10 million, which will exceed 8.2 million cancer deaths and 1.5 million diabetes deaths. Almost half of the prescribed antibiotics in hospitals are unnecessary or inappropriate, as research showed. Appropriate antimicrobial therapy dose no longer include, a simple selection of empirical or therapeutic antibiotics that will suitably act on the causative agent in a suitable patient, but involves a set of complex procedures for which the entire Antibiotic Stewardship team (A-team) is required. A particular problem is the antibiotics used in the last line of treatment when other antibiotics no longer function (the so-called antibiotic reserve, AR) whose quantity has increased significantly in recent years. Despite evidence of the benefits of A-team team implementation, it has still not been recognized and applied in Croatia. As a consequence, the A-team implementation project was started in the General Hospital “Dr. Tomislav Bardek “Koprivnica on 1st September 2017.
OBJECTIVE:
To show through the multidisciplinary collaboration of infectologists – physician, microbiologist -physician and clinical pharmacist, as compulsory A-team members, who implement and coordinate interventions aimed at the proper application of antimicrobial therapy and the ability to improve treatment outcomes.
METHODS:
Using a prospective audit and feedback strategy which means an empirically applied antibiotic evaluation and audit with intervention and feedback to a clinician, the clinical pharmacist validates and issues AR based on the interpretation of the findings of the microbiologist and the clinical findings of the infectologist.
RESULTS:
In the period of 7 months (from 01.09.2017 to 31.03.2018) of the A-team implementation compared to the same period (from 01.09.2016 to 31.03.2017) without A-team, the consumption of defined daily doses of AR to 100 bed-days was reduced and thus financial spending. The aforementioned correlates with reduced number of patients treated with AR for 57%, ie from 938 to 402 (Fisher exact test, OR = 2,40, 95%CI = <2,13; 2,72>, p < 2.2*10^-16 => p < 0,001) without significant impact on mortality (the general mortality rate before A-team was 43.66 and after 40.30).
CONCLUSION:
Multidisciplinary approach of A-team enabled optimization of clinical outcomes while minimizing unwanted consequences of using AR.
LITERATURE:
- Barlam TF, Cosgrove SE, Abbo LM, et al. Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis 2016; 62:e51.
- Holubar M, Deresinski S. Antimicrobial stewardship in hospital setting. UpToDate®. 2018.
- European Centre for Disease Prevention and Control: Antimicrobial resistance surveillance in Europe 2016. Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS-Net) Stockholm: ECDC; 2017.
- O’Neill J. Antimicrobial resistance: tackling a crisis for the health and wealth of nations. Rev Antimicrob Resist. 2014. http://amr-review.org/Publications.
- Marquet K, Liesenborgs A, Bergs J, Vleugels A, Claes N. Incidence and outcome of inappropriate in-hospital empiric antibiotics for severe infection: a systematic review and meta-analysis. Crit Care. 2015;19:63.
- Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan PJ. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol. 2011 Feb;32(2):101-14.
- Davey, P., Marwick, C.A., Scott, C.L., Charani, E., McNeil, K., Brown, E. et al, Interventions to improve antibiotic prescribing practices for hospital inpatients. in: P. Davey (Ed.) Cochrane Database Syst Rev. John Wiley & Sons, Ltd, Chichester, UK; 2017.
- Oberjé EJM, Tanke MAC, Jeurissen PPT. Antimicrobial Stewardship Initiatives Throughout Europe: Proven Value for Money. Infectious Disease Reports. 2017;9(1):6800.
- European Centre for Disease Prevention and Control. Infographics about antibiotic stewardship programmes. Poveznica: https://antibiotic.ecdc.europa.eu/en/infographics-about-antibiotic-stewa…. Accessed: 23.01.2018.
