{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T08:46:54Z","timestamp":1782895614792,"version":"3.54.5"},"reference-count":44,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the impact of a multidisciplinary antimicrobial stewardship program (mASP) on adherence to recommended antimicrobial therapy in neurosurgical units.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A quasi-experimental study was conducted in Thammasat University Hospital between May 2020 and June 2022. Our primary outcome was adherence to recommended antimicrobial therapy, and secondary outcomes included clinical improvement, 30-day infectious disease\u2013related mortality, antimicrobial use, and incidence of infection with multidrug-resistant (MDR) pathogens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 688 antimicrobial orders were reviewed during the study. The most prescribed antimicrobial for empiric therapy was piperacillin\/tazobactam (266\/688, 39.9%), and the most common source of infection was the respiratory tract (321\/688, 46.7%). The overall adherence rate to recommended antimicrobial therapy was higher in the mASP period (70.3% vs 62.5%; P = 0.029). The overall acceptance rate of mASP recommendations was 83.1%. Furthermore, the mean volumes of carbapenem (P = 0.005) and vancomycin (P = 0.045) use declined, while the trend of cefazolin use increased (coefficient, 26.88; 95% confidence interval, 13.53 to 40.24; P &amp;lt; 0.001) during the study period. The incidence of infections caused by MDR pathogens significantly declined (P = 0.012), especially for infections caused by carbapenem-resistant Acinetobacter baumannii (P = 0.043). There were no differences in the secondary outcomes, inclusive of the proportion of patients with clinical improvement and 30-day infectious disease\u2013related mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Implementation of an mASP in neurosurgical units was associated with improved adherence to recommended antimicrobial therapy, reduced use of broad-spectrum antibiotics, and a decline in the incidence of infections with MDR pathogens.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajhp\/zxag188","type":"journal-article","created":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T11:31:56Z","timestamp":1782041516000},"source":"Crossref","is-referenced-by-count":0,"title":["The impact of a multidisciplinary team on adherence to recommended antimicrobial therapy in neurosurgical units in Thailand"],"prefix":"10.1093","author":[{"given":"Kittiya","family":"Jantarathaneewat","sequence":"first","affiliation":[{"name":"Research Group in Infectious Diseases Epidemiology and Prevention, Faculty of Medicine, Thammasat University, Pathum Thani, and Center of Excellence in Pharmacy Practice and Management Research, Faculty of Pharmacy, Thammasat University , Pathum Thani ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pataravit","family":"Rukskul","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Thammasat University , Pathum Thani ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pornchai","family":"Yodwisithsak","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Thammasat University , Pathum Thani ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wadrawee","family":"Kaewwichai","sequence":"additional","affiliation":[{"name":"Neurosurgical Intensive Care Unit, Nursing Department, Thammasat University Hospital , Pathum Thani ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Camins","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anucha","family":"Apisarnthanarak","sequence":"additional","affiliation":[{"name":"Research Group in Infectious Diseases Epidemiology and Prevention, Faculty of Medicine, Thammasat University, Pathum Thani, and Division of Infectious Diseases, Faculty of Medicine, Thammasat University , Pathum Thani 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