Evidence map›Paper›PMID 40390037›Full record

ArticleJournal of pharmaceutical health care and sciences2025

Impact of an antimicrobial time-out program on antimicrobial consumption rate in hospitalized patients: a quasi-experimental study on the national antimicrobial stewardship program in Iran : Iranian antimicrobial stewardship program.

Mohammadreza Salehi, Marzieh Arabi, Hossein Khalili, Yunes Panahi, Erta Rajabi, Esmaeil Mohammadnejad, Amir-Mohammad Yaryari, Arash Seifi, Mitra Barati, Kousha Farhadi

Abstract read
In one paragraph

Article in Journal of pharmaceutical health care and sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Burden and Economic Impact of Antimicrobial Resistance inThe Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mohammadreza SalehiResearch Center for Antibiotic Stewardship & Antimicrobial Resistance, Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0000-0002-5538-7586
Marzieh ArabiDepartment of Infectious Diseases, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0009-0004-4714-2919
Hossein KhaliliResearch Center for Antibiotic Stewardship & Antimicrobial Resistance, Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0000-0002-1590-6396
Yunes PanahiPharmacotherapy Department, Faculty of Pharmacy, Baqiyatallah University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0000-0002-2504-8356
Erta RajabiDepartment of Infectious Diseases, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0009-0001-8061-5675
Esmaeil MohammadnejadResearch Center for Antibiotic Stewardship & Antimicrobial Resistance, Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0000-0002-2673-3646
Amir-Mohammad YaryariDepartment of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0009-0006-1992-9831
Arash SeifiResearch Center for Antibiotic Stewardship & Antimicrobial Resistance, Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0000-0002-6174-0315
Mitra BaratiPaediatric Infectious Diseases Research Centre, Iran University of Medical Science, Tehran, Iran.ORCID http://orcid.org/0000-0002-3443-0266
Kousha FarhadiDepartment of Infectious Diseases, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. koushafarhadi@gmail.com.ORCID http://orcid.org/0000-0002-4123-225X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study evaluated the impact of the national antimicrobial stewardship program (NASP) on the consumption of antimicrobial agents.

methodsA quasi-experimental study was conducted on hospitalized patients at a referral hospital in Tehran, Iran. We compared the antimicrobial-defined daily dose (DDD) and antimicrobial consumption index (ACI) between the third quarter of 2022 (before the implementation of NASP after the COVID-19 pandemic in October 2022) and the same timeframe in 2023, following the NASP implementation. The NASP was based on antimicrobial time-out assessment. Within 72 h of prescribing meropenem, imipenem, linezolid, vancomycin, voriconazole, caspofungin, and amphotericin B liposomal, infectious disease specialists audited the clinical and microbiological evidence of patients to assess whether it was consistent with the correct prescription.

resultsThe antimicrobial consumption rate was assessed in 13,794 and 15,030 hospitalized patients during the third quarter of 2022 and the third quarter of 2023, respectively. The mean length of hospital stay and mortality rate showed no significant differences. The consumption of all restricted antimicrobials decreased. This reduction was significant for imipenem, caspofungin, vancomycin, and linezolid. The total cost of antimicrobial agents had a 22.24% reduction after the NASP implementation (P = 0.01).

conclusionsThe antimicrobial time-out program was associated with a reduction in the use of antimicrobials, including imipenem, linezolid, and vancomycin and antifungals, such as caspofungin without increasing the length of stay and mortality rate. The NASP implementation can be recommended as a beneficial method for reducing the use of broad-spectrum antimicrobials.

Indexed as

Antibiotic consumptionAntimicrobial stewardshipAntimicrobial time-outHospitalsIranTherapeutic use

Identifiers

PMID40390037
PMCPMC12090655

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.