Loading
Life sciences · Review
International Journal of Drug Delivery Technology · October 16, 2026
No summary has been generated for this record yet. What follows is drawn from its source metadata only.
Review.
No findings were extractable from the material analysed.
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
The source did not state who this applies to in practice.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
This record has not been graded across any dimension yet. Treat the label above as provisional and read the source.
What is missing. This record has no bottom line, key findings, reported figures, evidence dimensions. That is a gap in the analysis, not a judgement about the study.
BackgroundAntimicrobial resistance threatens the effectiveness of infection treatment and increases the risk of prolonged illness, complications, healthcare expenditure, and mortality.Hospitals are major sites of antimicrobial exposure because patients frequently receive empirical broad-spectrum therapy, surgical prophylaxis, treatment for healthcare-associated infections, or prolonged therapy in the presence of diagnostic uncertainty.Antimicrobial stewardship programmes aim to optimise agent selection, dose, route, timing, and duration while preserving timely and effective treatment for serious infections.Objective This systematic review evaluated the effectiveness, safety, and implementation of hospital antimicrobial stewardship interventions across general medicine, surgery, intensive care, and oncology.The principal outcomes were antimicrobial consumption, prescribing appropriateness, de-escalation, intravenous-to-oral conversion, duration of treatment, surgical-prophylaxis compliance, antimicrobial resistance, Clostridioides difficile infection, clinical cure, length of stay, readmission, and mortality.Methods PubMed/MEDLINE, Embase, Scopus, Web of Science, CINAHL, and the Cochrane Library were searched from database inception to January 31, 2026.Supplementary searches were undertaken through Google Scholar, ClinicalTrials.gov,institutional guidance repositories, and reference-list screening.Randomised trials, prospective and retrospective comparative cohorts, interrupted timeseries analyses, and controlled before-and-after studies were eligible when they evaluated a hospital antimicrobial stewardship intervention and reported prescribing, microbiological, safety, or patient outcomes.Two reviewers independently screened studies, extracted data, and evaluated methodological quality.Owing to substantial heterogeneity in specialties, interventions, antimicrobial metrics, pathogens, and outcomes, findings were synthesised narratively. ResultsThe search identified 4,186 records, including 4,074 records from electronic databases and 112 records from supplementary sources.After removal of 1,126 duplicates, 3,060 titles and abstracts were screened.A total of 2,788 records were excluded, and 272 reports were sought for full-text retrieval.Fourteen reports could not be obtained, leaving 258 full-text reports for eligibility assessment.Of these, 234 were excluded for predefined reasons, and 24 studies were included in the qualitative synthesis.Prospective audit and feedback, formulary restriction with expert review, antibiotic time-outs, syndrome-specific guidance, rapid diagnostic support, procalcitonin-guided discontinuation, and pharmacist-led review generally reduced antimicrobial exposure or improved appropriateness without increasing mortality or treatment failure.In surgery, stewardship improved the timing, selection, and discontinuation of prophylactic antibiotics, although education alone was frequently insufficient.In intensive care, procalcitoninsupported discontinuation reduced treatment duration, whereas evidence for routine spectrum de-escalation was more variable.Oncology interventions reduced unnecessary vancomycin and broad-spectrum treatment and supported earlier discontinuation in selected clinically stable patients with febrile neutropenia.Effects on resistance were inconsistent and required longer observation than prescribing outcomes. ConclusionsHospital antimicrobial stewardship improves antimicrobial prescribing across medicine, surgery, intensive care, and oncology without compromising clinical safety when programmes preserve prompt empirical therapy for patients with severe infection.The most effective approaches combine leadership, infectious-diseases and pharmacy expertise, prospective review, syndrome-specific guidance, microbiological support, clear accountability, measurement, and feedback.Stewardship must be adapted to specialtyspecific risks and should not be reduced to indiscriminate restriction of antimicrobial treatment.