{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T16:41:08Z","timestamp":1786552868199,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Am Coll Clin Pharm"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antimicrobial stewardship programs (ASPs) aim to optimize antimicrobial use in intensive care units (ICUs), where high antimicrobial consumption, antimicrobial resistance, and complex pharmacokinetics complicate therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective, observational, pre\u2013post study was conducted in the ICU of a tertiary hospital in T\u00fcrkiye over 6\u2009months (October 2024\u2014April 2025), comprising a 3\u2010month pre\u2010ASP observation period and a 3\u2010month ASP period. During the ASP period, a clinical pharmacist integrated within a interprofessional team, including infectious disease physicians, conducted prospective audit and feedback in collaboration with the ICU team. Antimicrobial appropriateness was evaluated as the primary objective, while antimicrobial consumption (days of therapy [DOT] and length of therapy [LOT]), intervention characteristics, acceptance rates, and 30\u2010day mortality were assessed as secondary objectives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 160 patients and 466 antimicrobial treatments (235 pre\u2010ASP; 231 post\u2010ASP) were evaluated. Consistent with the primary outcome, antimicrobial appropriateness improved significantly following ASP implementation, with the inappropriateness rate decreasing from 81.7% to 8.7% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), corresponding to an 89.6% reduction in antimicrobial\u2010related problems. Regarding secondary outcomes, overall antimicrobial exposure declined, with total DOT and LOT decreasing by 8.5% and 19.5%, respectively, although median DOT and LOT per patient\u2010day did not differ significantly between periods. The most frequent pharmacist interventions were dose adjustment (38.3%), initial dose selection (35.2%), and infusion duration modification (15.4%), with a 98.1% acceptance rate. Thirty\u2010day mortality decreased from 56.0% to 38.8% (relative risk [RR] 0.699, 95% confidence interval [CI] 0.505\u20130.968;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027). In adjusted patient\u2010level analyses, pharmacist intervention was independently associated with lower mortality (adjusted odds ratio [OR] 0.331, 95% CI 0.148\u20130.743;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Integration of a clinical pharmacist into a interprofessional\u00a0audit and feedback process significantly improved antimicrobial appropriateness and reduced antimicrobial\u2010related problems. An associated reduction in 30\u2010day mortality was observed after adjustment for illness severity; however, this finding warrants confirmation in larger prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jac5.70192","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T09:40:19Z","timestamp":1771580419000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Pharmacist\u2010Led Antimicrobial Stewardship on Antibiotic Use in Intensive Care: A Prospective Audit and Feedback Approach"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4284-255X","authenticated-orcid":false,"given":"B\u00fc\u015fra","family":"Ergen","sequence":"first","affiliation":[{"name":"Faculty of Pharmacy, Clinical Pharmacy Department Marmara University  Istanbul 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