{
  "abstract": "Background/objectives\n\nAntimicrobial resistance (AMR) is a major global health threat, and multidrug-resistant organisms (MDROs) are associated with worse outcomes than susceptible infections. Pharmacists are central to antimicrobial stewardship (AMS), yet their impact in confirmed MDRO infections is unclear. We evaluated pharmacist-involved AMS on clinical and process outcomes in MDRO infections and quantified pooled effects on clinical outcomes.Methods\n\nFollowing PRISMA 2020, seven databases were searched (inception-December 2025) for pharmacist-involved AMS studies in patients with confirmed MDRO infections (Tier A) or in mixed populations from which MDRO-specific outcomes were extractable (Tier B), classified into Tier A, B, or C by outcome extractability. Random-effects meta-analyses were performed a priori for outcomes with ≥2 studies, with fixed-effect sensitivity and GRADE ratings.Results\n\nForty-nine studies were included (7 Tier A, 6 Tier B, 36 Tier C); quantitative synthesis was restricted to the 13 Tier A/B studies with MDRO-specific outcome data, and certainty of evidence was very low for all five pooled outcomes. Pharmacist involvement consistently improved process outcomes (time to therapy, de-escalation, antimicrobial consumption) and reduced mortality and readmissions in several subgroups. Pooled random effects RRs (95% CI) were: 30-day mortality, 0.64 (0.41-1.00; I² = 28%, non-significant); in-hospital mortality, 0.72 (0.57-0.92; I² = 6%, significant); 30-day readmission, 0.50 (0.31-0.79; I² = 0%, significant); recurrent infection, 0.51 (0.25-1.04); and acute kidney injury, 1.01 (0.54-1.87; both non-significant, I² = 0%).Conclusions\n\nMulticomponent AMS interventions involving pharmacists were consistently associated with improved stewardship processes and significant reductions in in-hospital mortality and 30-day readmission, though evidence certainty remained very low. Larger, prospective studies with harmonized outcome definitions are needed to confirm the clinical benefit's magnitude.",
  "abstract_shown": true,
  "affiliations": [
    "College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar.",
    "QU Health, Qatar University, Doha P.O. Box 2713, Qatar."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ziad G Nasr",
      "orcid": "0000-0002-3520-4818"
    },
    {
      "affs": [
        0
      ],
      "name": "Alaa Sharafeldin",
      "orcid": "0009-0005-9926-6240"
    },
    {
      "affs": [
        0
      ],
      "name": "Mouda Hamdan"
    },
    {
      "affs": [
        0
      ],
      "name": "Zainab Al-Muhsin"
    },
    {
      "affs": [
        0
      ],
      "name": "Dima Baker"
    },
    {
      "affs": [
        1
      ],
      "name": "Dina Abushanab",
      "orcid": "0000-0002-4162-8617"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/35rz271xe0069.bib",
  "cited_by": 0,
  "doi": "10.3390/antibiotics15100955",
  "fulltext_url": "https://europepmc.org/articles/PMC13700879",
  "id": "35rz271xe0069",
  "issns": [
    "2079-6382"
  ],
  "landing_url": "https://europepmc.org/article/MED/42938696",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2402|Antibiotic Use and Resistance"
    ]
  ],
  "openalex": "W7214361183",
  "pdf_url": "https://europepmc.org/articles/PMC13700879?pdf=render",
  "pmcid": "PMC13700879",
  "pmid": "42938696",
  "published": "2026-09-25",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/35rz271xe0069.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:22:24Z",
      "native_id": "MED:42938696",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42938696"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "openalex:2402|Antibiotic Use and Resistance",
      "subfield": "microbiology"
    }
  ],
  "title": "Impact of Pharmacist-Involved Antimicrobial Stewardship Interventions on Clinical and Process Outcomes in Multidrug-Resistant Organism Infections: A Systematic Review and Meta-Analysis.",
  "title_text": "Impact of Pharmacist-Involved Antimicrobial Stewardship Interventions on Clinical and Process Outcomes in Multidrug-Resistant Organism Infections: A Systematic Review and Meta-Analysis.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:22:24Z",
  "url": "https://research.draconitic.com/paper/35rz271xe0069",
  "venue": "Antibiotics (Basel, Switzerland)",
  "versions": []
}