Antimicrobial resistance (AMR) is a global health crisis exacerbated by policies like China’s Volume-Based Procurement (VBP), which may inadvertently increase antimicrobial overuse. This study evaluates a clinical pharmacist-led Antimicrobial Stewardship (AMS) program with prospective audit for special-restricted antimicrobials under VBP.

A retrospective quasi-experimental interrupted time-series analysis compared pre-intervention (2022) and post-intervention (2023–2024) data at Tongji Hospital, a tertiary hospital in Wuhan, China. Key metrics included Antimicrobial Use Density (AUD), prescription rationality, antimicrobial costs, and multidrug-resistant infection rates.

The intervention significantly improved prescription appropriateness for special-restricted antimicrobials (80.24% vs. 93.83%, P < 0.005) and reduced AUD (47.87 vs. 34.25, P < 0.001). Total antimicrobial costs decreased by 41.26%, with a reduction in the incidence of multidrug-resistant infections from 0.084% to 0.062% (P < 0.05). Carbapenem use correlated with CRKP isolation rates (R = 0.62, P < 0.05). Clinical pharmacists rejected 10.24% of prescriptions, all accepted by physicians.

Pharmacist-led prospective audits optimize antimicrobial use under VBP, mitigate resistance risks, and reduce costs, while acknowledging that concurrent infection control measures may have contributed to these trends. This model may inform similar interventions in other institutions, particularly those in resource-limited settings.

Urgent care locations remain a target for antimicrobial stewardship initiatives due to high rates of inappropriate antibiotic prescribing, particularly for respiratory tract infections. This study evaluated the impact of an antimicrobial stewardship bundle at urgent care sites on appropriate antibiotic prescriptions.

Retrospective, observational, pre- and post-analysis.

Four advanced urgent care sites affiliated with an academic medical institution.

Urgent care patients evaluated for respiratory tract infections.

An antimicrobial stewardship bundle including clinician-signed stewardship posters, over-the-counter medication prescription pads, and an educational campaign was introduced to advanced urgent care sites from October to November 2024. Respiratory tract infections were tiered by antibiotic appropriateness (1 = always appropriate; 2 = sometimes appropriate; 3 = never appropriate). Adults with tier 2 or 3 diagnoses from December 2023 to January 2024 (pre-group) and December 2024 to January 2025 (post-group) were included. The primary outcome was proportion of appropriate antibiotic prescriptions.

Two hundred and seventy-five patients with tier 2 and tier 3 indications were screened; 200 patients were included. Following implementation of the antimicrobial stewardship bundle, there was no significant difference in rates of appropriate antibiotic prescriptions for tier 2 and tier 3 respiratory infections between the pre- and post-groups (76% vs 74%, respectively; P = 0.68). After implementation, more patients received appropriate antibiotics for tier 2 indications (77% vs 95%; p = 0.13). The most prescribed antibiotic agents amongst both groups were amoxicillin-based antibiotics (15%) and azithromycin (15%).

This study highlights challenges and opportunities for outpatient antimicrobial stewardship practices.

Expanded public health (PH) antimicrobial stewardship (AS) funding to Healthcare-Associated Infections (HAI)/Antimicrobial Resistance (AR) programs led to hiring of pharmacists with AS expertise in health departments. A PH pharmacists’ community of practice (CoP) consisting of pharmacists who work for local, state, and federal PH agencies was initiated to share resources and activities from PH AS interventions and collaborations. The objective of this evaluation was to characterize publications identified by PH pharmacists’ CoP that helped advance AS implementation by PH agencies.

In March 2024, a 34-item electronic questionnaire was developed and distributed to the PH pharmacists’ CoP requesting nominations of articles that highlight interventions and data sources essential to PH AS practice. Respondents were asked to submit 1–10 scientific articles published from 2014 to 2023 most relevant to their work in PH AS implementation and/or in achieving programmatic deliverables. Articles with ≥ 3 nominations were selected for review.

Of 39 PH pharmacists in the CoP, 24 (62%) responded with 106 article nominations. Respondents held state-level positions (83%), had <2 years of PH AS experience (54%), and were often from the southeastern United States (25%). Publications in acute care settings were most frequent (54, 51%), followed by outpatient (47, 44%), and long-term care (45, 42%). A total of eleven articles were selected for review.

Scientific publications impactful to AS PH practice can serve as a valuable resource for AS programs and pharmacists in PH. Dissemination of PH AS activities can inform enhancement of AS programs in the PH sector.

This study aimed to evaluate the impact of an Antimicrobial Stewardship Program (ASP) on antibiotic consumption and mortality rates in the intensive care units (ICUs) of a national pediatric referral hospital in Lima, Peru.

The study population included patients under 18 years of age admitted to five ICUs during two distinct periods: prior to the implementation of the ASP (2016–2017) and following its implementation (2017–2018). Days of therapy (DOT) per 1,000 patient days were calculated to evaluate antibiotic consumption, and the results were compared between the two periods. Mortality rates and length of stay (LOS) were also assessed and compared. Differences in antibiotic consumption, mortality, and LOS were analyzed using χ2 and t tests.

Following ASP implementation, average antibiotic consumption decreased significantly from 750 DOT to 660 DOT (p = 0.01), indicating a 12% reduction. Notable declines in antibiotic use were observed specifically in the cardiology and burns ICUs, as well as in the subgroups of carbapenems, glycopeptides, and oxazolidinones. However, the analysis revealed no significant reduction in mortality rates or LOS following the implementation of the ASP.

Our findings suggest that the implementation of an ASP in pediatric ICUs is associated with a reduction in antibiotic consumption. These results underscore the critical importance of ASPs in promoting appropriate and rational use of antibiotics. Further research should explore the complex relationship between inappropriate antibiotic use and mortality in pediatric ICUs to clarify how ASP implementation may contribute to reducing mortality in this vulnerable population.

This study aims to assess the knowledge and determine the level of compliance with human immunodeficiency virus (HIV) post exposure management (PEM) among dentists.

A descriptive cross-sectional study was done among 114 dentists.

Study was done among dentists in two Nigerian tertiary hospitals.

All dentists available, who consented to the study during the period of data collection were included in the sample. Three cadres of dentists; house officers, residents and consultants, were involved in the study.

Using self-administered questionnaires, information was sought on knowledge of managing exposures-first aid and prophylaxis as well as compliance when exposed. Data was analyzed using the SPSS statistical software.

Nearly all respondents, 111(97.4%), reported having heard about HIV PEM. Exposure incidents most frequently identified by respondents were needlestick injuries, 111(97.4%). Majority of the dentists recognized practices such as flushing exposed mucous membranes with water, 97(85.1%), and washing skin injuries with soap and water, 75(65.8%), as first aid for exposure incidents, while 20(17.5%) endorsed inappropriate measures like applying bleach to the wound. Seventy-one (62.3%) reported awareness of a HIV PEM protocol in their institution while 39(33.3%) were uncertain, with only 25(21.9%) reporting routine practice of the protocol. Fifty-six (49.1%) of the respondents had experienced an exposure of which only 30(53.6 %) reported and 32(57.1%) requested blood tests for the source patient(s).

The level of compliance with post exposure management is inadequate, therefore there is a need to update the knowledge and device methods of encouraging compliance with HIV PEM protocol among dentists.

A follow-up survey of Special Pathogen Treatment Centers (SPTCs) was conducted to assess their readiness to provide critical care interventions to confirmed and suspected viral hemorrhagic fever (VHF) patients after the COVID-19 pandemic.

An electronic survey with 54 multiple-choice and free-response questions assessing VHF critical care capabilities was sent to 74 US SPTCs in April 2023.

Fourteen SPTCs (19%) completed the survey. Most respondents were prepared to provide intubation/mechanical ventilation (79%), pharmacologic cardioversion (79%), renal replacement therapy (71%), and defibrillation (71%) to suspected and confirmed VHF patients. Few were ready to provide cricothyrotomy (36%), extracorporeal membranous oxygenation (ECMO) (29%), or code status (14%). Factors impacting institutions’ ability to provide critical care to a VHF patient included staff safety (71%) and clinical futility (50%). Less than half (36%) reported that the COVID-19 pandemic positively affected their facility’s ability to care for VHF patients, while 21% indicated the pandemic prompted their facility to be better prepared to care for a VHF patient.

Most responding SPTCs reported capability for critical care interventions, although fewer had policies governing code status, ECMO, and cricothyrotomy. Institutions were less prepared to manage a VHF patient after the COVID-19 pandemic, highlighting challenges such as staff turnover and less support for training and equipment maintenance. Given that special pathogen outbreaks continue to occur globally, governments and healthcare institutions should institute measures to recruit, support, and retain staff to ensure critical care readiness for special pathogen patients.

This study assessed the perception and practice regarding Antimicrobial Stewardship (AMS) and knowledge about antibiotics among Community Pharmacy Dispensers (CPD) in selected municipalities of Kavrepalanchowk district, Nepal.

A cross-sectional study was conducted among CPD of the community pharmacies of Banepa, Dhulikhel, and Panauti in Kavrepalanchowk district, Nepal.

A structured self-administered questionnaire was administered to 58 CPD selected through census sampling technique. The questionnaire comprised of questions assessing the knowledge of antibiotics, perception, and practice regarding AMS. A bivariate analysis was done to determine association between demographic variables and dependent variables.

Majority of respondents (60.3%) had medium level of knowledge regarding antibiotics, 46.6% of the respondents had low practice scores, and 50% of the respondents had positive perceptions of AMS. A positive correlations of knowledge with perception (p = 0.0001) and practice (p = 0.019) was seen. Education level had a significant association with knowledge levels (p = 0.035) and perception about AMS (p = 0.043). A significant association between gender with AMS practice was also observed (p = 0.002).

The practice of AMS in community pharmacies is low despite of medium level of knowledge on antibiotics among the community pharmacy dispensers. Establishing AMS protocols specific to community pharmacies in Nepal can lead to standardized practices and improve adherence to AMS principles.