ArticleAntibiotics (Basel, Switzerland)2026
Contextual Determinants of Clinical Pharmacists' Contributions to Team-Based Antimicrobial Stewardship in Jordanian Hospitals: A Realist-Informed Qualitative Study.
Article in Antibiotics (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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Who cites it
1 citing paper in PubMed.
- When Antibiotics Are Refused: A Qualitative Study of Patient-Provider Communication, Trust, and Reported or Anticipated Responses in Jordan.Healthcare (Basel, Switzerland) · 2026Article
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Authors and funding
9 authors.
Funding
Abstract
BACKGROUND/
objectivesClinical pharmacists contribute pharmacotherapy expertise to antimicrobial stewardship (AMS), but antimicrobial prescribing remains a multidisciplinary process led by treating clinicians. In physician-centered hospital systems, pharmacists' contributions may be integrated into prescribing decisions to varying degrees depending on the organizational structures, interprofessional relationships, workflow integration, and prescribing cultures. This study aimed to explore how contextual and interprofessional factors shape the integration of clinical pharmacists' antimicrobial stewardship contributions within multidisciplinary prescribing decisions in Jordanian hospitals.
methodsA multi-site qualitative study was conducted across nine Jordanian hospitals. Semi-structured interviews were conducted with 26 clinical pharmacists involved in antimicrobial reviews in intensive care and general medical units. Interviews incorporated the critical incident technique to elicit examples of accepted and rejected stewardship recommendations. Data were analyzed using a realist-informed approach to develop context-mechanism-outcome configurations explaining variations in pharmacists' reported AMS contribution.
resultsPharmacotherapy expertise was necessary but not sufficient for pharmacists' recommendations to shape antimicrobial prescribing. Leadership endorsement, structured multidisciplinary rounds, and formal documentation pathways activated mechanisms of legitimacy, credibility, and workflow visibility, supporting reported uptake of dose optimization, therapeutic drug monitoring, and selected de-escalation recommendations. In contrast, prescriber-led hierarchies, limited documentation pathways, workload pressures, and defensive prescribing cultures activated mechanisms of self-limitation, risk aversion, and limited recommendation uptake, particularly for discontinuation, duration control, and narrowing of broad-spectrum therapy.
conclusionsStrengthening AMS requires not only formal committees and guidelines but also team-based structures that integrate pharmacists' pharmacotherapy expertise into antimicrobial review while preserving clinicians' ultimate prescribing responsibility.
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