{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T13:12:21Z","timestamp":1788873141587,"version":"build-2803163510"},"reference-count":28,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"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=\"S0899823X26105017_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Emergency departments in tertiary care are critical areas for decision-making regarding antimicrobial use,however, they are often underrepresented in antimicrobial stewardship (AMS) interventions. This study evaluates the impact of a nurse-driven antimicrobial stewardship intervention in a medical emergency unit of a tertiary care facility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105017_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A quasi experimental pre\u2013post study was conducted in the Emergency Medical Outpatient department in a tertiary care center. Following a baseline assessment of antimicrobial use patterns conducted by a team of trained stewardship nurses, salient intervention targets were identified and implemented. AMS nurses actively reviewed antimicrobial prescriptions, reinforced adherence to institutional guidelines, monitored device- related practices and diagnostic utilization, and participated in audit and feedback with clinical teams. Data on patient characteristics, infection type, culture practices, antibiotic use, and guideline adherence were collected and compared between pre-intervention and intervention phases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105017_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Following the intervention, compliance with hospital antibiotic guidelines improved from 82.4% to 91.0%. The proportion of cultures collected before initiating antibiotics increased from 23% to 40.3%, with a corresponding rise in culture positivity from 8% to 22%. An increase in antibiotic de-escalation practices was also noted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105017_as4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This nurse-driven antimicrobial stewardship intervention was associated with more rational antimicrobial use, improved diagnostic utilization, and strengthened infection control practices. Integrating stewardship activities into nursing workflows represents a feasible approach to strengthening AMS in high-volume acute care settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2026.10501","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T07:00:31Z","timestamp":1783666831000},"page":"931-937","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating a nurse-led, audit-based antimicrobial stewardship in the medical emergency unit of a tertiary level hospital"],"prefix":"10.1017","volume":"47","author":[{"given":"Rupamdeep","family":"Kaur","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/009nfym65","id-type":"ROR","asserted-by":"publisher"}],"name":"Post Graduate Institute of Medical Education and 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World Health Organization. Global action plan on antimicrobial resistance. Geneva: World Health Organization, 2015. https:\/\/www.who.int\/publications\/i\/item\/9789241509763. 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World Health Organization. Antimicrobial resistance fact sheet, 2023. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/antimicrobial-resistance. Accessed July 10, 2025."},{"key":"S0899823X26105017_ref19","doi-asserted-by":"publisher","DOI":"10.12968\/bjon.2025.0295"},{"key":"S0899823X26105017_ref21","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics10020200"},{"key":"S0899823X26105017_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.emc.2018.06.012"},{"key":"S0899823X26105017_ref4","unstructured":"4. O\u2019Neill, J. Tackling drug-resistant infections globally: final report and recommendations. The review on antimicrobial resistance, 2016. https:\/\/amrreview.org\/sites\/default\/files\/160525_Final%20paper_with%20cover.pdf. Accessed May 22, 2017."},{"key":"S0899823X26105017_ref18","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-042321"},{"key":"S0899823X26105017_ref27","first-page":"64","article-title":"Nurses\u2019 knowledge and experiences of antimicrobial stewardship: a systematic review","volume":"33","author":"Blackburn","year":"2025","journal-title":"Wound Pract Res"},{"key":"S0899823X26105017_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2021.01.003"},{"key":"S0899823X26105017_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2024.107306"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X26105017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:59:33Z","timestamp":1788872373000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X26105017\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,10]]},"references-count":28,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["S0899823X26105017"],"URL":"https:\/\/doi.org\/10.1017\/ice.2026.10501","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,10]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. 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