ArticleInfection and drug resistance2026
Impact of a Pharmacist-Led Grid-Based Stewardship Program on the Association Between Antimicrobial Use and Resistance: A 7.5-Year Interrupted Time-Series Analysis in a Chinese Tertiary Hospital.
Article in Infection and drug resistance, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Whether antimicrobial stewardship programs (ASPs) modulate the association between antimicrobial use and resistance remains uncertain. Long-term evidence for precision stewardship models in Chinese tertiary hospitals is scarce. Methods: A 7.5-year interrupted time-series analysis (2018-2025) was conducted at a 1900-bed Chinese tertiary hospital. A pharmacist-led, grid-based precision ASP-stratifying 29 departments via Boston Matrix and integrating four synergistic pillars-was implemented in July 2020. Segmented regression models, adjusted for seasonality and autocorrelation, evaluated changes in antimicrobial use density (AUD), clinical/economic outcomes, and the temporal association ( Results: The ASP was associated with an immediate AUD reduction (-25.6%, Conclusion: This grid-based precision ASP was associated with sustained reductions in antimicrobial use and costs, and improved clinical outcomes. It was also associated with changes in the temporal relationship between AUD and MDRO detection rates. These alterations suggest this approach may mitigate selective pressure driving resistance, although causality cannot be established in this observational study. This framework may serve as a policy-aligned reference for large tertiary hospitals and provide useful insights to inform local and national antimicrobial stewardship initiatives.
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