{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T08:59:09Z","timestamp":1785401949092,"version":"3.56.0"},"reference-count":31,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"unspecified","delay-in-days":85,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S2732494X26103131_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Early review of intravenous (IV) antimicrobial therapy is central to antimicrobial stewardship (AMS), however scalable models for general medical patients are limited. We evaluated a pharmacist-led digital intervention to optimize IV antimicrobial prescribing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26103131_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospective, quasi-experimental before-and-after study was conducted between May 2022 to February 2023 across six general medicine units at a tertiary hospital. AMS recommendations were delivered electronically via Microsoft Teams\u00ae. Adult inpatients receiving IV antimicrobials for &gt;24 hours were included, excluding those with COVID-19, under Infectious Diseases consultation or receiving palliative care. The primary outcome was median IV antimicrobial duration. Secondary outcomes included AMS recommendation type, recommendation acceptance, length of stay (LOS), 30-day infection-related readmission, IV therapy recommencement, and inpatient mortality. Antibacterial consumption was analyzed from July 2021 to through December 2024 to evaluate sustained impact.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26103131_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 723 antimicrobial orders (474 treatment episodes in 458 patients), median IV duration was comparable between phases (intensive: 2.75 days; baseline: 3.00 days). LOS was shorter during the intensive phase compared to baseline (5.5 vs 7.6 days;\n                      <jats:italic>P<\/jats:italic>\n                      = .04), particularly in patients without bacteremia. Readmissions and mortality were unchanged. Of 400 AMS recommendations, 67% were IV-to-oral switches; overall acceptance was 78%. Piperacillin-tazobactam use declined, and sustained reductions in aminoglycosides, ampicillin and IV flucloxacillin were observed. A reduction in total antibiotic prescribing (combined IV and oral prescribing) was also observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26103131_as4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The digital pharmacist-led AMS intervention did not reduce IV duration, likely reflecting strong baseline prescribing, but was associated with shorter LOS and a reduction in total antibacterial use. This program offered a scalable, sustainable alternative to resource-intensive face-to-face models.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ash.2026.10313","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:38:53Z","timestamp":1774611533000},"source":"Crossref","is-referenced-by-count":0,"title":["EMERGE: Early antiMicrobial stEwaRdship for GEneral medicine patients\u2014targeting inpatient intravenous therapy greater than 24 hours"],"prefix":"10.1017","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3499-8652","authenticated-orcid":false,"given":"Sharmila","family":"Khumra","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05dbj6g52","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Infectious Diseases and Immunology, Austin Health"},{"name":"Austin Health, 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