{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T08:08:31Z","timestamp":1788854911909,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"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":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Suboptimal antibiotic prescribing for pediatric community\u2010acquired pneumonia (CAP) contributes to avoidable harm and antimicrobial resistance, yet evidence on pharmacist\u2010led stewardship in low\u2010 and middle\u2010income countries remains limited. The objective of this study is to evaluate the impact of a pharmacist\u2010led antimicrobial stewardship intervention on antibiotic prescribing appropriateness for pediatric CAP in Vietnam.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a quasi\u2010experimental before\u2010and\u2010after study at a provincial maternal and pediatric referral hospital. Using monthly stratified systematic sampling, we reviewed 560 unique paper\u2010based medical records of children aged 2\u2009months to 5\u2009years who were hospitalized with a primary diagnosis of CAP and received systemic antibiotics (280 records in January\u2013June 2024 and 280 in January\u2013June 2025). The intervention comprised locally adapted prescribing guidance, two in\u2010person educational seminars, printed and digital prescribing tools, and case\u2010triggered face\u2010to\u2010face audit and feedback. Appropriateness was evaluated against the hospital protocol, Vietnamese national guidance, the Vietnam National Drug Formulary, and manufacturer information. Proportions were compared between periods; exploratory univariable logistic regression examined factors associated with inappropriate prescribing before the intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall appropriateness increased from 60.36% (169\/280) to 86.79% (243\/280;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Dose appropriateness increased from 67.14% to 90.71% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and dosing\u2010interval appropriateness increased from 90.36% to 98.57% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Before the intervention, age\u2009&lt;\u200912\u2009months (odds ratio [OR] 2.1, 95% confidence interval [CI] 1.3\u20133.5;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and combination therapy (OR 4.6, 95% CI 1.75\u201312.1;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) were associated with inappropriate prescribing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A structured pharmacist\u2010led stewardship intervention was associated with substantial improvement in antibiotic prescribing appropriateness for pediatric CAP, driven mainly by better dosing and dosing intervals. These findings support sustained pharmacist participation in pediatric antimicrobial stewardship in provincial Vietnamese hospitals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jac5.70279","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T08:35:07Z","timestamp":1788251707000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pharmacist\u2010Led Antimicrobial Stewardship Optimizes Antibiotic Prescribing for Pediatric Community\u2010Acquired Pneumonia in Vietnam: A Quasi\u2010Experimental Before\u2010and\u2010After Study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7799-4523","authenticated-orcid":false,"given":"Thang","family":"Nguyen","sequence":"first","affiliation":[{"name":"Department of Pharmacology and Clinical Pharmacy Can Tho University of Medicine and Pharmacy  Can Tho City Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trang Thuy Thi","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Women's and Children's Hospital of Kien Giang  Rach Gia An Giang Province Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5461-0782","authenticated-orcid":false,"given":"Thu Ngoc Chau","family":"Phan","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Clinical Pharmacy Can Tho University of Medicine and Pharmacy  Can Tho City Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ly Truong Cam","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Clinical Pharmacy Can Tho University of Medicine and Pharmacy  Can Tho City Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3857-9420","authenticated-orcid":false,"given":"Phuong Minh","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Can Tho University of Medicine and Pharmacy  Can Tho City Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"Pneumonia in Children","author":"World Health Organization","year":"2022"},{"key":"e_1_2_12_3_1","volume-title":"Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report 2022","author":"World Health Organization","year":"2022"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.15172\/pneu.2015.6\/671"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.17843"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/20499361221141771"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022\u2010059201"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra035092"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000003317"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/ash.2024.342"},{"key":"e_1_2_12_11_1","volume-title":"Core Elements of Hospital Antibiotic Stewardship Programs: 2024 Update","author":"Centers for Disease Control and Prevention","year":"2024"},{"key":"e_1_2_12_12_1","volume-title":"WHO AWaRe Antibiotic Book: Practical Guidelines on the Prescribing and Use of Antibiotics","author":"World Health Organization","year":"2022"},{"key":"e_1_2_12_13_1","volume-title":"Pocket Book of Hospital Care for Children: Guidelines for the Management of Common Childhood Illnesses","author":"World Health Organization","year":"2013"},{"key":"e_1_2_12_14_1","volume-title":"Guidelines for Antibiotic Use in Vietnam (Decision No. 708\/QD\u2010BYT, March 2, 2015)","author":"Vietnam Ministry of Health","year":"2015"},{"key":"e_1_2_12_15_1","first-page":"41","article-title":"Current Situation of Antibiotic Use in the Treatment of Community\u2010Acquired Pneumonia in Children Under 5\u2009Years Old at Can Tho Children's Hospital in 2019\u20102020","volume":"37","author":"Nguyen T. T. L.","year":"2023","journal-title":"Can Tho Journal of Medicine and Pharmacy"},{"key":"e_1_2_12_16_1","volume-title":"Clinical Guidelines for Management of Pediatric Pneumonia","author":"Kien Giang Obstetrics and Pediatrics Hospital","year":"2021"},{"key":"e_1_2_12_17_1","volume-title":"National Drug Formulary Vietnam 2022","author":"Vietnam Ministry of Health","year":"2022"},{"key":"e_1_2_12_18_1","first-page":"247","article-title":"Lobar Pneumonia and Bacterial Pathogens in Vietnamese Children","volume":"24","author":"Tran Q. 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