Work

Pharmacist-led multidisciplinary review of carbapenem use in inpatients: A quasi-experimental study

Year: 2026

Type: article

Abstract: • A pharmacist-led multidisciplinary team model for carbapenem stewardship was established. • Significant post-intervention rise in rational carbapenem prescription and re-evaluation rates. • Clinician acceptance of pharmacist interventions increased markedly from 50.50% to 91.67%. • Effectively identified and rectified major causes of irrational carbapenem use. • Provides a practical and effective antimicrobial stewardship strategy for hospitals. To evaluate the effect of a clinical pharmacist-led multidisciplinary team (MDT) review model on the appropriateness of carbapenem use among inpatients. This study employed a quasi-experimental, pre-post design. We retrospectively analyzed 1086 inpatient cases receiving carbapenem therapy between 2020 and 2024. From 2023 onward, an MDT comprising clinical pharmacists, infectious disease specialists, and microbiologists systematically reviewed medical orders against standardized criteria and provided evidence-based recommendations. Post-intervention, the appropriateness of initial carbapenem prescriptions increased from 77.08% to 83.79%, while re-evaluation appropriateness improved from 78.94% to 87.00% ( P < 0.05). Pharmacist intervention acceptance rates rose significantly from 56.04% to 82.35% ( P < 0.05). Additionally, median hospital length of stay decreased (19 vs. 15 days), with notable reductions in ICU admission (59.95% vs. 31.50%) and mortality rates (15.51% vs. 4.28%) ( P < 0.001). Multivariable regression identified hepatic/renal dysfunction and hypoalbuminemia as independent risk factors for ICU admission, while ICU admission itself strongly predicted mortality. Notably, the detection rates of carbapenem-resistant Klebsiella pneumoniae and Pseudomonas aeruginosa increased during the intervention period. The clinical pharmacist-led MDT model enhances carbapenem prescribing appropriateness and fosters interprofessional collaboration. Its implementation was associated with shorter hospital stays and improvements in key clinical indicators, including reduced ICU admission and mortality. However, the observed shifts in resistant pathogen epidemiology underscore that antimicrobial stewardship strategies must be integrated with rigorous infection prevention and control measures to simultaneously optimize therapeutic outcomes and mitigate resistance.

Source: Journal of Global Antimicrobial Resistance

DOI: 10.1016/j.jgar.2026.02.001