{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:55:37Z","timestamp":1790574937954,"version":"4.1.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontierspartnerships.org"],"crossmark-restriction":true},"short-container-title":["J. Pharm. Pharm. Sci."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are major causes of in-hospital mortality and antimicrobial resistance (AMR), particularly in low- and middle-income countries (LMICs). Carbapenems are commonly used due to their broad-spectrum activity; however, their efficacy in real-world clinical practices comparing carbapenem with non-carbapenem regimens in these settings is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare clinical outcomes between patients receiving carbapenem-based and non-carbapenem therapy for HAP and VAP at a tertiary care hospital in Pakistan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 93 adult patients (HAP: n = 62, VAP: n = 31) over the period of 1\u00a0year. Demographics, comorbidities, microbial isolates, treatment regimen, and clinical outcomes were analyzed using descriptive statistics, chi-square tests, and risk ratio calculations with 95% confidence interval. Multivariable logistic regression was planned to adjust for confounders but was not feasible due to missing severity score and biomarker data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      HAP was more common in females (63%), while VAP showed a male predominance (52%). The most common pathogens were\n                      <jats:italic>Acinetobacter spp.<\/jats:italic>\n                      (HAP: 11.3%; VAP: 19.4%) and\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      (HAP: 11.3%; VAP: 16.1%). The most prevalent comorbidity in HAP was diabetes mellitus (38.7%). Carbapenem-based therapy (meropenem) was used in 65.6% of cases and the most frequently prescribed non-carbapenem agents were piperacillin-tazobactam, ceftazidime, and colistin. No significant difference in mortality was observed between carbapenem and non-carbapenem therapy in HAP (31.6% vs. 29.2%; RR 1.08, 95% CI 0.50\u20132.36, p = 0.840) or VAP (65.2% vs. 50.0%; RR 1.30, 95% CI 0.61\u20132.77, p = 0.440). VAP was associated with significantly higher crude mortality than HAP (61.3% vs. 30.6%; p = 0.005). Crude mortality rates appeared highest among patients in the\n                      <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                      group (70.4%) and\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      group (31.3%), though treatment group difference were not statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      In this single-center retrospective cohort, no statistically significant association between carbapenem-based therapy and all-cause in-hospital mortality was detected in HAP or VAP. Crude mortality appeared highest among patients with\n                      <jats:italic>Acinetobacter<\/jats:italic>\n                      and\n                      <jats:italic>Pseudomonas<\/jats:italic>\n                      isolates. However, wide confidence intervals, treatment-selection bias, and unadjusted analyses preclude definitive conclusions. These findings should be considered hypothesis-generating, requiring confirmation in adequately powered, larger prospective studies.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/jpps.2026.17336","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:10:13Z","timestamp":1790572213000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Carbapenem-based versus non-carbapenem therapy for hospital-acquired and ventilator-associated pneumonia in a resource-limited setting: a retrospective cohort study of clinical outcomes"],"prefix":"10.3389","volume":"29","author":[{"given":"Uroosa","family":"Kanwal","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi","place":["Karachi, Pakistan"]},{"name":"Department of Pharmacy Practice, Faculty of Pharmacy, Salim Habib 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Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Falak","family":"Abro","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Liaquat National Hospital","place":["Karachi, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tehreem","family":"Ansari","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Dow University Hospital, Dow University of Health Sciences","place":["Karachi, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najia","family":"Rahim","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Dow College of Pharmacy, Dow University of Health Sciences","place":["Karachi, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabya","family":"Munawar","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, 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