{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:08:19Z","timestamp":1791889699461,"version":"4.3.4"},"reference-count":38,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X26104802_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>\n                      Antimicrobial Stewardship Programs (ASPs) need healthcare economic analyses to support and inform ASP strategies. This work aimed to determine whether widely available artificial intelligence (AI) platforms like Microsoft Copilot\n                      <jats:sup>TM<\/jats:sup>\n                      could facilitate healthcare economics analyses for ASP programs without dedicated healthcare economic supports.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104802_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>\n                      AI (Microsoft Copilot\n                      <jats:sup>TM<\/jats:sup>\n                      ) was prompted to develop a cytomegalovirus prophylaxis protocol for lung transplant recipients using only PubMed-indexed articles. Copilot\n                      <jats:sup>TM<\/jats:sup>\n                      was then prompted to produce probabilistic samples of simulated patients from aggregate statistics of a 165-patient cohort from Vanderbilt University Medical Center and to analyze cost-effectiveness across four distinct cytomegalovirus prophylaxis protocols, including its own.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104802_as4\">\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Tertiary care academic medical center, including outpatient and inpatient environments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104802_as5\">\n                    <jats:title>Patients or participants:<\/jats:title>\n                    <jats:p>Simulated patient data was developed via random, single-blind, probabilistic selection from pre-defined aggregate cohort statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104802_as6\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The AI-generated prophylaxis protocol was evidence-based without hallucination, but this conservative protocol relied on outdated evidence and was associated with significant increases in expected per-patient cost (mean +$4740,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .01) compared to recent guideline-based and institutional protocols. AI independently identified and executed sensitivity analyses, which revealed that in this simplified model, letermovir use had a large impact on expected per-patient cost.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104802_as7\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      The AI-proposed protocol was less cost-effective, but data suggest that careful prompting can provide appropriate PubMed-indexed literature to support ASP protocol development. Additionally, CoPilot\n                      <jats:sup>TM<\/jats:sup>\n                      provided a thorough cost-effectiveness analysis comparing all potential and existing protocols. With appropriate oversight, AI and Microsoft Copilot\n                      <jats:sup>TM<\/jats:sup>\n                      can conduct healthcare economic analyses suitable for ASP strategic planning and implementation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2026.10480","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T08:08:38Z","timestamp":1780906118000},"page":"915-922","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["Updating CMV protocols in lung transplant patients: a single-center case study modeling use of generative AI for antimicrobial stewardship protocol development and economic impact analysis"],"prefix":"10.1017","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1901-5558","authenticated-orcid":false,"given":"Kyle T.","family":"Enriquez","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05dq2gs74","id-type":"ROR","asserted-by":"publisher"}],"name":"Vanderbilt University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8040-9620","authenticated-orcid":false,"given":"Augusto","family":"Dulanto Chiang","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4355-4471","authenticated-orcid":false,"given":"Casey","family":"Smiley","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0774-7698","authenticated-orcid":false,"given":"Milner","family":"Staub","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"S0899823X26104802_ref21","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-020-00333-z"},{"key":"S0899823X26104802_ref34","doi-asserted-by":"publisher","DOI":"10.1086\/598952"},{"key":"S0899823X26104802_ref12","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2025.1547450"},{"key":"S0899823X26104802_ref27","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms12112360"},{"key":"S0899823X26104802_ref36","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-020-00767-w"},{"key":"S0899823X26104802_ref9","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad787"},{"key":"S0899823X26104802_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.idh.2025.09.003"},{"key":"S0899823X26104802_ref20","doi-asserted-by":"publisher","DOI":"10.2196\/50638"},{"key":"S0899823X26104802_ref28","doi-asserted-by":"publisher","DOI":"10.1186\/s40780-024-00352-y"},{"key":"S0899823X26104802_ref16","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaf695.2348"},{"key":"S0899823X26104802_ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s10916-023-01925-4"},{"key":"S0899823X26104802_ref23","unstructured":"23. 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Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}