Interrupted time series of pharmacist-led pneumonia review in UAE

Clinical pharmacist-led post-prescription review was associated with a substantial rise in the therapeutic appropriateness of antimicrobial treatment for adults hospitalized with community-acquired pneumonia at a 200-bed tertiary care hospital in Dubai. In the single-center quasi-experimental interrupted time-series study, the proportion of antimicrobial regimens judged appropriate across selection, dosing and duration increased from 24.4% in the pre-intervention phase to 83.3% in the post-intervention phase. The analysis included adults aged 18 to 65 years admitted with community-acquired pneumonia between July 2021 and June 2023.

Researchers compared prescribing before and after the post-prescription review process was introduced. Segmented logistic regression identified an immediate increase in therapeutic appropriateness at the intervention point, with an adjusted odds ratio of 22.9, a 95% confidence interval of 9.8 to 53.6 and p<0.001. The model found no significant pre-intervention trend and no significant change in slope after the intervention.

According to the investigators, this pattern was consistent with a sustained rather than progressively increasing improvement during the post-intervention period. Post-prescription review is a component of antimicrobial stewardship in which prescribed antimicrobial therapy is assessed against clinical guidelines and the patient’s clinical response. The study was undertaken because community-acquired pneumonia is a common cause of hospitalization in the United Arab Emirates, while antimicrobial prescribing practices continue to vary despite established international clinical guidelines.

The Dubai findings provide local evidence on whether structured review can improve the therapeutic appropriateness of treatment in this clinical setting. Clinical pharmacist recommendations were accepted in 85.2% of cases, showing that treating clinicians frequently acted on guidance provided after antimicrobial prescriptions had been selected. Hospital length of stay was designated as a secondary clinical outcome, while the primary outcome was therapeutic appropriateness across antimicrobial selection, dosing and duration.

The reported effect centered on prescribing quality: the intervention phase had an appropriateness rate of 83.3%, compared with 24.4% before implementation, and the segmented regression estimated a marked step change at the point of introduction. The study’s design and setting limit the strength of conclusions that can be drawn. It was conducted at one tertiary care hospital in Dubai, enrolled a defined age range of hospitalized adults with community-acquired pneumonia and evaluated a post-prescription review process within one institution.

As a quasi-experimental interrupted time-series analysis, the results show a temporal association between the intervention and improved therapeutic appropriateness rather than establishing how much of the change, if any, would have occurred without the review process. The researchers stated that larger multicenter trials are warranted to assess the intervention more broadly. Within those limits, the study supports strengthening antimicrobial stewardship in the UAE through structured post-prescription review of community-acquired pneumonia treatment.

Subject of Research: Clinical pharmacist-led post-prescription review of antimicrobial therapy for adults hospitalized with community-acquired pneumonia in the UAE.

Article Title: Infectious diseases clinical pharmacist-led post-prescription review and therapeutic appropriateness in community-acquired pneumonia: an interrupted time-series study in the United Arab Emirates

Article References: Elnajjar, S., Noor Harun, S., & Beshir, S. (2026). Infectious diseases clinical pharmacist-led post-prescription review and therapeutic appropriateness in community-acquired pneumonia: an interrupted time-series study in the United Arab Emirates. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14351-x

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DOI: 10.1186/s12879-026-14351-x

Keywords: community-acquired pneumonia, antimicrobial stewardship, clinical pharmacy, post-prescription review, antibiotic prescribing, interrupted time series, Dubai, United Arab Emirates, therapeutic appropriateness, Infectious, diseases, clinical