Effect of Pharmacist Involvement in Emergency Department Microbiological Culture Follow‐Up Services on Clinical Outcomes and Workflow: A Systematic Review

ABSTRACT Introduction Patients are often discharged from the emergency department ( ED ) while results from microbiological cultures are still pending. Most institutions provide culture follow‐up, but there is wide variability in the structure and personnel involved. Pharmacists are well suited for involvement in culture follow‐up services; though no systematic review has evaluated the impact of pharmacists in this clinical role. Objectives To assess the impact of pharmacists in ED culture follow‐up services on: (1) clinical outcomes; and (2) workflow. To characterize pharmacist roles/responsibilities as part of ED culture follow‐up services. Methods A search of the following databases was conducted: Medline, International Pharmaceutical Abstracts, and Web of Science. Studies were included if they described culture follow‐up services with pharmacist involvement in an ED setting. Screening and quality assessment were performed using Covidence software and the Newcastle‐Ottawa Scale, respectively. Data extraction focused on study design, participants, types of cultures, and clinical and time‐based outcomes. Results Thirty‐three studies met inclusion criteria. Pharmacist involvement was consistently associated with reduced time from culture result to first attempted patient contact (ranging from 9.1–62.3 h, compared with 23.6–72 h without pharmacist involvement). Some studies found absolute reductions in ED revisit or readmission rates ranging from 4.2% to 15.4%, while others found no difference. Pharmacists significantly improved the appropriateness of antimicrobial therapy, with fewer missed interventions and less unnecessary antibiotic use. Current literature is limited by heterogeneity in study designs, small sample sizes, and a lack of randomized controlled trials. Conclusion Pharmacist involvement in ED culture follow‐up services demonstrates clear benefits in reducing time to initial review and patient contact. Further research is needed to address methodological limitations of current literature and to explore the benefits of negative culture follow‐up services, expanded pharmacy services through collaborative practice agreements, and strategies to enhance the efficiency of culture follow‐up services.