Pharmacist-led stewardship improved antibiotic appropriateness and outcomes in adult HAP or VAP patients.

This randomized controlled trial investigated the impact of a pharmacist-led antimicrobial stewardship program on adult patients with hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP). The study population comprised 699 patients, with 366 assigned to the intervention group and 334 to standard care at a tertiary care hospital. The intervention included daily medication reviews, culture-guided optimization, therapeutic drug monitoring, duration optimization, adverse event monitoring, and multidisciplinary communication training.

At the primary outcome of day three, the intervention group demonstrated significantly higher rates of appropriate antimicrobial prescriptions (77.6%) compared to the standard care group (60.8%), with an odds ratio of 2.26 (95% CI: 1.65–3.09). Secondary analyses indicated significantly reduced antimicrobial exposure and healthcare utilization, as well as improved clinical outcomes, though specific numerical data and p-values for these secondary endpoints were not reported.

Safety and tolerability data, including adverse events, serious adverse events, discontinuations, and overall tolerability, were not reported in the study. The authors note that this randomized controlled trial highlights the importance of antimicrobial stewardship programs as an evidence-based strategy to address antimicrobial resistance and optimize patient care in HAP. However, the absence of reported safety data and specific effect sizes for secondary outcomes limits the ability to fully assess the risk-benefit profile of the intervention.