{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T05:20:31Z","timestamp":1761110431687,"version":"3.37.3"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2018,12,11]],"date-time":"2018-12-11T00:00:00Z","timestamp":1544486400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,5,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To compare pharmacist-led prescribing changes and associated 30-day revisit rates across different regimens for patients discharged from an emergency department (ED) with a diagnosis of community-acquired pneumonia (CAP).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>An observational, retrospective cohort analysis was conducted of patients who were discharged from an ED over a 4-year period with a diagnosis of CAP. Patient demographics, clinical characteristics, antibiotic selection and comorbidity and condition severity scores were collected for two cohorts: 2012\u201313 (before protocol change) and 2014\u201315 (post-protocol change). During January 2014, a pharmacist-led protocol change with prescriber education was implemented to better align ED treatment practices with clinical practice guidelines. The primary endpoint was the change in prescribing practices across the two cohorts.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Key findings<\/jats:title>\n                  <jats:p>A total of 741 patients with CAP were identified, including 411 (55.5%) patients in 2012\u201313 and 330 (44.5%) in 2014\u201315. Prescribing of macrolide monotherapy regimens decreased significantly following protocol change (70.1% versus 42.7%; difference: 27.4%, 95% CI: 23.8\u201331.0%) with a reciprocal increase in macrolide\/\u03b2-lactam combination prescribing (6.3\u201321.8%; difference: 15.5%, 95% CI: 12.9\u201318.1%). A total of 12.2% of patients who received macrolide\/\u03b2-lactam combination treatment revisited a network ED within 30 days due to worsening pneumonia, compared to 8.6% of patients who received macrolide monotherapy treatment (P = NS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The current study showed a significant increase in antibiotic prescribing compliance following a pharmacist-driven protocol change and education, but no statistical difference in rates of return for macrolide monotherapy versus other regimens.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1111\/ijpp.12497","type":"journal-article","created":{"date-parts":[[2018,12,11]],"date-time":"2018-12-11T11:39:53Z","timestamp":1544528393000},"page":"279-285","source":"Crossref","is-referenced-by-count":6,"title":["Prescribing trends and revisit rates following a pharmacist-driven protocol change for community-acquired pneumonia in an emergency department\u2020"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9661-0895","authenticated-orcid":false,"given":"David E","family":"Zimmerman","sequence":"first","affiliation":[{"name":"Division of Pharmacy Practice, Duquesne University School of Pharmacy, Pittsburgh, PA, USA"},{"name":"University of Pittsburgh Medical Center \u2013 Mercy Hospital, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2913-2042","authenticated-orcid":false,"given":"Jordan R","family":"Covvey","sequence":"additional","affiliation":[{"name":"Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Branden D","family":"Nemecek","sequence":"additional","affiliation":[{"name":"Division of Pharmacy Practice, Duquesne University School of Pharmacy, Pittsburgh, PA, USA"},{"name":"University of Pittsburgh Medical Center \u2013 Mercy Hospital, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony J","family":"Guarascio","sequence":"additional","affiliation":[{"name":"Division of Pharmacy Practice, Duquesne University School of Pharmacy, Pittsburgh, PA, USA"},{"name":"Allegheny General Hospital, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Wilson","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center \u2013 Mercy Hospital, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry R","family":"Freedy","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center \u2013 Mercy Hospital, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed H","family":"Yassin","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center \u2013 Mercy Hospital, Pittsburgh, PA, USA"},{"name":"University of Pittsburgh School of Medicine, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2018,12,11]]},"reference":[{"key":"2021031319193324400_ijpp12497-bib-0001","doi-asserted-by":"crossref","first-page":"727","DOI":"10.3201\/eid1405.071011","article-title":"Increasing hospital admissions for pneumonia, England","volume":"14","author":"Trotter","year":"2008","journal-title":"Emerg Infect Dis"},{"key":"2021031319193324400_ijpp12497-bib-0002","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1136\/thoraxjnl-2015-207688","article-title":"Increasing burden of community-acquired pneumonia leading to hospitalization, 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