{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T08:08:32Z","timestamp":1788854912675,"version":"build-2803163510"},"reference-count":22,"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>Inappropriate antimicrobial use in emergency departments (EDs) contributes significantly to antimicrobial resistance (AMR). Pharmacist\u2010led antimicrobial stewardship programs (ASPs) can potentially optimize antimicrobial prescribing and improve patient outcomes; however, their specific impact in the ED setting warrants further evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study evaluated adult patients receiving empiric antimicrobial therapy in the ED of a large, tertiary\u2010care, community teaching hospital in South Florida before (pre\u2010ASP) and after (post\u2010ASP) the implementation of a pharmacist\u2010led ASP. The primary outcome was the appropriateness of empiric antimicrobial therapy based on societal guidelines and local resistance patterns. Secondary outcomes included the use and appropriateness of antipseudomonal and anti\u2010Methicillin\u2010resistant Staph Aureus (MRSA) agents, as well as the appropriateness of vancomycin dosing. Logistic regression analyses identified predictors of inappropriate prescribing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 324 patients (median age, 65\u2009years; 53.4% female) were included, with 162 patients in both the pre\u2010ASP and post\u2010ASP groups. Appropriate empiric regimens did not differ significantly (49.4% vs. 53.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.44). There were significant reductions in unnecessary pseudomonal (54.9% vs. 35.2%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and MRSA coverage (23.5% vs. 13.6%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02), and vancomycin dosing appropriateness trended upward post\u2010ASP (52.6% vs. 77.3%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.06). The post\u2010ASP group demonstrated significant reductions in aztreonam (5.2% vs. 0.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), piperacillin\/tazobactam (22.3% vs. 14.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02), and vancomycin use (18.0% vs. 11.0%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02), with increased ceftriaxone (17.5% vs. 33.0%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and metronidazole prescribing (1.4% vs. 7.0%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). Independent predictors of inappropriate prescribing included home wound care (Adjusted odds ratio [aOR], 5.36; CI, 1.3\u201336.2), male sex (aOR, 1.72; CI, 1.1\u20132.8), and gastrointestinal infection (aOR, 2.67; CI, 1.1\u20136.7).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although the overall rate of appropriate empiric therapy remained unchanged, the pharmacist\u2010led ASP was associated with reduced broad\u2010spectrum antimicrobial usage and enhanced vancomycin dosing accuracy. These findings suggest that pharmacists can help optimize ED antimicrobial use, although additional strategies are needed to improve overall appropriateness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jac5.70287","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T06:51:32Z","timestamp":1788331892000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of a Pharmacist\u2010Led Antimicrobial Stewardship Program on Empiric Prescribing Appropriateness in the Emergency Department: A Retrospective Cohort Study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7125-9830","authenticated-orcid":false,"given":"Ali A.","family":"Althubyani","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy University of Tabuk  Tabuk Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1245-4088","authenticated-orcid":false,"given":"Benito Fernandez","family":"Lopez","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services Memorial Hospital West  Pembroke Pines Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lily G.","family":"Fechtmeyer","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services Memorial Hospital West  Pembroke Pines Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3984-7987","authenticated-orcid":false,"given":"Daria K.","family":"Szczepanek","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services Memorial Hospital West  Pembroke Pines Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa A.","family":"Catalano","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services Memorial Hospital West  Pembroke Pines Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7515-0105","authenticated-orcid":false,"given":"Kyle","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services Memorial Hospital West  Pembroke Pines Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7171-7015","authenticated-orcid":false,"given":"Dana J.","family":"Holger","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services Memorial Hospital West  Pembroke Pines Florida USA"},{"name":"Department of Pharmacy Practice, Barry and Judy Silverman College of Pharmacy Nova Southeastern University  Fort Lauderdale Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"CDC \u201cAntibiotic Resistance Threats in the United States 2019 \u201daccessed February 9 2025 https:\/\/stacks.cdc.gov\/view\/cdc\/82532."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu542"},{"key":"e_1_2_11_4_1","unstructured":"C.CairnsandK.Kang \u201cNational Hospital Ambulatory Medical Care Survey: 2020 Emergency Department Summary Tables 2020 \u201daccessed February 9 2025 https:\/\/stacks.cdc.gov\/view\/cdc\/121911."},{"key":"e_1_2_11_5_1","volume-title":"Most Frequent Reasons for Emergency Department Visits, 2018 #286","author":"Weiss A. 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