Impact of complex interventions on antibacterial therapy and etiological diagnostics in community-acquired pneumonia: a 12-month pre- and post-intervention study
Ablakimova N. Rachina S. Smagulova G. Vlasenko A. Mussina A. Zhylkybekova A. Yessenzhulova A. Koshmaganbetova G.K. Iztleuov Y.
2025Frontiers Media SA
Frontiers in Pharmacology
2025#16
Background: Antimicrobial resistance (AMR) is a growing global health concern, with community-acquired pneumonia (CAP) remaining a leading cause of hospitalization and empirical antibiotic use. However, adherence to clinical guidelines in CAP management is inconsistent, particularly in resource-limited settings. Objectives: This study aimed to evaluate the impact of a complex antimicrobial stewardship intervention on the quality of antibacterial therapy and diagnostic practices in hospitalized patients with CAP in Aktobe, Kazakhstan. Methods: A 12-month pre- and post-intervention study was conducted in two multidisciplinary hospitals. The intervention included educational sessions, implementation of protocol-based care, and improved access to diagnostic tools. Key indicators assessed included adherence to national antibiotic guidelines, use of severity scoring tools, timely antibiotic administration, microbiological diagnostics, and step-down therapy. Results: Significant improvements were observed in several indicators: guideline-adherent antibiotic prescribing increased from 75% to 93.5% (p < 0.001), step-down therapy from 2.7% to 8.2% (p = 0.021), and use of CURB-65/CRB-65 from 0% to 8.7% (p < 0.001). Use of urinary antigen tests increased from 0% to 12% (p < 0.001), while evaluation of antibiotic effectiveness at 48–72 h rose from 40.2% to 70.1% (p < 0.001). Multivariable logistic regression confirmed the independent impact of the intervention, adjusting for factors such as age, pneumonia severity, and shift type (day shift vs off-duty shift). Conclusion: A targeted, context-specific intervention significantly improved key quality indicators in CAP management. These findings support the effectiveness of multifaceted stewardship strategies in improving clinical practice and mitigating AMR. Copyright
antimicrobial stewardship , health education , medical records , pneumonia , point-of-care testing
Text of the article Перейти на текст статьи
Department of Pharmacology, Clinical Pharmacology, West Kazakhstan Marat Ospanov Medical University, 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
Department of Pathological Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
Respiratory Medicine and Allergology Department, Aktobe Medical Center, Aktobe, Kazakhstan
Department of Evidence-Based Medicine and Scientific Management, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
Department of Radiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
Department of Pharmacology
Hospital Therapy Department No. 2
LLC Digital Technologies and Platforms
Department of Pathological Physiology
Respiratory Medicine and Allergology Department
Department of Evidence-Based Medicine and Scientific Management
Department of Radiology
10 лет помогаем публиковать статьи Международный издатель
Книга Публикация научной статьи Волощук 2026 Book Publication of a scientific article 2026