Antimicrobial stewardship interventions in hospitalized adults with community-acquired pneumonia: a systematic review and meta-analysis
Ablakimova N. Rachina S. Silva H.R.D. Vlasenko A. Smagulova G. Mussina A. Sakhanova S. Zhylkybekova A. Tleumagambetova B. Karimoldayeva D. Kozhantayeva S.
July 2025Springer Science and Business Media Deutschland GmbH
European Journal of Clinical Microbiology and Infectious Diseases
2025#44Issue 71533 - 1550 pp.
Purpose: This systematic review and meta-analysis evaluate the effectiveness of ASPs in managing community-acquired pneumonia (CAP), focusing on antibiotic optimization and resistance mitigation. Methods: Comprehensive literature searches were conducted in PubMed, Scopus, and Web of Science using PICOS criteria. Studies involving adults with CAP exposed to ASPs were included. Data on clinical, economic, diagnostic, and treatment outcomes were extracted. Random-effects meta-analysis using R software pooled effect sizes. Outcomes reported in at least three studies were analyzed for robustness. Results: ASPs did not significantly impact in-hospital mortality, length of stay, 30-day readmissions, sample collection rates, or intravenous antibiotic duration. However, notable improvements included shorter time to clinical stability and a 31% reduction in 30-day mortality. Legionella urinary antigen testing frequency increased nearly threefold, and the time from admission to antibiotic initiation was reduced. Enhanced adherence to timely antibiotic administration and recommended regimens was observed, though outcome variability persisted. Conclusion: ASPs significantly improve CAP management by enhancing clinical stability and accelerating antibiotic initiation. Multifaceted strategies, including rapid diagnostics and clinician education, yield clinical benefits. However, outcome variability suggests a need for tailored interventions. Future research should isolate specific ASP components influencing prescriber behavior. Ongoing investment in education, diagnostics, and interdisciplinary collaboration is vital to optimize CAP treatment and combat antibiotic resistance.
Attitudes , Community-acquired infections , Disease management , Health knowledge , Pneumonia , Practice
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Department of Pharmacology, Clinical Pharmacology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
Department of Hospital Pharmacy, Aktobe Regional Perinatal Center, Aktobe, Kazakhstan
Hospital Therapy Department No. 2, I.M.Sechenov First Moscow State Medical University, Moscow, Russian Federation
LLC Digital Technologies and Platforms, Moscow, Russian Federation
Scientific and Practical Center, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
Department of Pathological Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
Department of Internal Diseases No. 1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
Respiratory Medicine and Allergology Department, Aktobe Medical Center, Aktobe, Kazakhstan
Department of Otolaryngology and Ophtalmology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
Department of Pharmacology
Department of Hospital Pharmacy
Hospital Therapy Department No. 2
LLC Digital Technologies and Platforms
Scientific and Practical Center
Department of Pathological Physiology
Department of Internal Diseases No. 1
Respiratory Medicine and Allergology Department
Department of Otolaryngology and Ophtalmology
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