Speakers - 2026

Title: Pharmacist led digital surveillance of antibiotic adjustment in pulmonary infections caused by ceftriaxone resistant escherichia coli and klebsiella pneumoniae

Abstract

Ceftriaxone-resistant Escherichia coli and Klebsiella pneumoniae increasingly cause pneumonia in general wards. Inappropriate or delayed adjustment of empirical antibiotics after the final antibiotic susceptibility test (AST) results may worsen outcomes. Previous studies suggested that pharmacist involvement in antimicrobial stewardship has improved antibiotic use and clinical outcomes in patients with pneumonia, reducing treatment duration and hospital stay without increasing mortality. To address this issue, we will use existing hospital records to describe current treatment patterns for adults with pneumonia caused by ceftriaxone-resistant E. coli or K. pneumoniae at National Taiwan University Hospital Hsinchu Branch, enrolling adults hospitalized from January 2023 to December 2025 with pneumonia caused by ceftriaxone-resistant E. coli or K. pneumoniae. Demographics, comorbidities, severity at T0 (time of final AST release), oxygen/vasopressor support, and antibiotic prescriptions will be collected from the hospital portal system. The primary outcome is whether the 48-hour appropriate-antibiotic rate improves after the new interface is introduced, using chi-square or Fisher’s exact tests to compare pre-implementation and post-implementation period whether the 48-hour appropriate-antibiotic rate improves after the new interface is introduced; a key secondary outcome is a 14-day composite of death, ICU transfer, invasive ventilation, vasopressor use, or persistent fever ≥ 72 hours from T0 . Routine electronic medical record data will be used to calculate To-to-adjustment intervals and to develop a pharmacist-led digital surveillance interface that lists cases without initiation of a pathogen-susceptible regimen within 48 hours. This pharmacist priority review interface will be implemented in collaboration with the hospital information technology team as a prototype stewardship tool. This portal-embedded interface will function as a real-time dashboard that automatically lists eligible cases once the final AST is released. Each row will display the patient’s ward, organism, current antibiotics, T0, and the hours since T0. The list can be sorted by ward, organism, or adjustment time, and episodes without initiation of a pathogen-susceptible regimen within 48 hours will be highlighted as priority-review cases. The study is in the implementation phase, with data extraction planned to begin in 2026; early descriptive outputs from the digital workflow will be presented. Findings will inform antimicrobial stewardship and guide future pharmacist-driven interventions.

The audience take away from presentation:

• The audience will be able to apply the presented workflow to create or refine their own digital surveillance processes for monitoring antibiotic adjustment. By seeing how routine EMR data can be organized into a simple, sortable dashboard with automatic 48-hour alerts, participants can implement similar tools in their hospitals to improve the timeliness and accuracy of antimicrobial stewardship.
• The workflow provides a practical way to detect delayed antibiotic adjustments using data they already have, reducing manual chart review and supporting faster, more accurate clinical decision-making. Clinicians and pharmacists can apply the same approach to improve efficiency in antimicrobial stewardship, while hospital IT staff can adapt the interface design to streamline their own surveillance tools.
• Yes. The interface offers a practical solution by consolidating key clinical information into a single, easy-to-interpret dashboard. This reduces manual chart review, simplifies workflow design, and allows clinicians and system developers to detect delayed antibiotic adjustments more efficiently with minimal technical complexity.