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Nosocomial Infections in ICU / Pneumonia and Respiratory Infections · Journal article
BMC Infectious Diseases · September 3, 2026
Encouraging direction, but not yet definitive.
A single-center interrupted time-series study in Dubai found that implementation of infectious diseases clinical pharmacist-led post-prescription review was associated with a dramatic increase in therapeutic appropriateness of antimicrobial therapy for community-acquired pneumonia, from 24.4% to 83.3%, with high acceptance of recommendations (85.2%). The effect was immediate and sustained, but evidence is limited to one center and relies on process measures rather than hard clinical outcomes.
Single-center, quasi-experimental interrupted time-series design. Adult patients aged 18–65 years hospitalized with community-acquired pneumonia at a 200-bed tertiary care hospital in Dubai, United Arab Emirates.. Intervention: Infectious diseases clinical pharmacist-led post-prescription review process assessing antimicrobial therapy against clinical guidelines and clinical response. Compared with: Pre-intervention standard prescribing practices (historical comparison via interrupted time-series). Single center in Dubai, United Arab Emirates.
Overall therapeutic appropriateness increased from 24.4% pre-intervention to 83.3% post-intervention Segmented logistic regression showed immediate step-level increase at intervention point (adjusted odds ratio 22.9, 95% CI: 9.8–53.6, p < 0.001) No significant pre-intervention trend and no significant change in slope post-intervention, indicating sustained improvement
Primary outcome is therapeutic appropriateness (surrogate); no hard clinical outcomes reported (e.g., mortality, readmission, clinical cure). Clinical pharmacist recommendation acceptance was high at 85.2%
Clinicians and stewardship programs should consider implementing formal post-prescription review processes led by infectious diseases clinical pharmacists for CAP, as this study demonstrates substantial improvements in adherence to guidelines. However, this finding requires validation in multicenter and international settings before broad implementation can be recommended.
A rigorous single-center interrupted time-series study with a large effect size and sustained improvement in a clinically relevant surrogate endpoint, but limited generalizability and requiring multicenter confirmation.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians and stewardship programs should consider implementing formal post-prescription review processes led by infectious diseases clinical pharmacists for CAP, as this study demonstrates substantial improvements in adherence to guidelines. However, this finding requires validation in multicenter and international settings before broad implementation can be recommended.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Community-acquired pneumonia (CAP) remains a common cause of hospitalization in the United Arab Emirates (UAE). Although well-established international clinical guidelines for CAP are available, antimicrobial prescribing practices continue to vary. This variation may contribute to inappropriate antibiotic use and the growing threat of antimicrobial resistance. Antimicrobial stewardship programs (ASPs) are shown to improve the quality of antimicrobial prescribing and reduce unnecessary antibiotic exposure. A core component of these programs is post-prescription review, which allows for the assessment of antimicrobial therapy based on clinical guidelines and patient’s clinical response. However, evidence evaluating the impact of post-prescription review on the management of CAP in the UAE is limited. This study aimed to assess temporal changes in the appropriateness of antimicrobial therapy following the implementation of a post-prescription review process in adults hospitalized with CAP. This study was conducted using a single-center, quasi-experimental interrupted time series design at a 200-bed tertiary care hospital in Dubai. The study period extended from July 2021 and June 2023. Adult patients aged 18–65 years admitted with CAP were included. Therapeutic appropriateness, assessed across antimicrobial selection, dosing, and duration, was the primary outcome. Length of hospital stay was evaluated as a secondary clinical outcome. Acceptance of clinical pharmacist recommendations during post-prescription review was also analyzed. Post-prescription review was associated with a significant increase in overall therapeutic appropriateness from 24.4% in the pre-intervention phase to 83.3% in the post-intervention phase. Segmented logistic regression demonstrated an immediate step-level increase at the point of intervention (adjusted odds ratio 22.9, 95% CI: 9.8–53.6, p < 0.001), with no significant pre-intervention trend and no significant change in slope post-intervention, indicating a sustained rather than progressive improvement. Acceptance of clinical pharmacist recommendations was high (85.2%). Introduction of post-prescription review was associated with a substantial improvement in therapeutic appropriateness for CAP. This UAE-based study supports strengthening regional antimicrobial stewardship programs through the post-prescription review processes. Larger multicenter trials are warranted. Clinical trial number: not applicable.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.