Impact of clinical pharmacist-led antimicrobial stewardship on antibiotic appropriateness, clinical outcomes, and antimicrobial consumption in hospital-acquired and ventilator-associated pneumonia: a randomized controlled trial

Background: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are major drivers of inappropriate antimicrobial use and resistance in hospitals. Clinical pharmacist-led antimicrobial stewardship programs (ASPs) are promising interventions for optimizing antimicrobial prescriptions and combating antimicrobial resistance. Methods: = 334) in a clinical trial setting. The intervention comprised daily medication reviews, culture-guided optimization, therapeutic drug monitoring, duration optimization, adverse event monitoring, and multidisciplinary communication training. The primary outcome was an appropriate antimicrobial prescription on day three. Results: = 0.04). Conclusion: Clinical pharmacist-led antimicrobial stewardship programs (ASPs) significantly reduced antimicrobial exposure and healthcare utilization, improving the appropriateness of antimicrobial prescriptions and clinical outcomes. These findings highlight the importance of ASPs as an evidence-based strategy to address antimicrobial resistance and optimize patient care in HAP.