Vol.74 No.4 July 2026

Impact of a template-based antimicrobial stewardship team pharmacist-led intervention on the management of Staphylococcus aureus bacteremia

Satoko Shiota¹⁾, Yasufumi Matsumura^{2, 3, 4)}, Minako Taninaga¹⁾, Masaki Yamamoto^{2, 3, 4)}, Hiroto Murase¹⁾ and Kazushige Takahashi¹⁾

¹⁾Department of Pharmacy, Saiseikai Noe Hospital
²⁾Department of Infectious Diseases, Saiseikai Noe Hospital
³⁾Department of Clinical Laboratory and Department of Infection Control and Prevention, Kyoto University Hospital
⁴⁾Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara, Sakyo-ku, Kyoto, Japan

Abstract

Staphylococcus aureus bacteremia (SAB) is well-known to be associated with a poor prognosis, and timely and appropriate clinical management is crucial for improving patient outcomes. At Saiseikai Noe Hospital, in a setting without full-time infectious disease physicians, an institutional guideline for SAB management based on evidence-based care bundles was developed, and since March 2019, a dedicated antimicrobial stewardship team (AST) pharmacist has provided treatment support for SAB using a standardized, guideline-derived intervention template. In this study, we evaluated the effectiveness of the template-based AST pharmacist-led intervention for managing SAB. We retrospectively analyzed the data of 112 adult patients diagnosed as having SAB at Saiseikai Noe Hospital between 2017 and 2020. Patients were classified into a pre-implementation group (n=61) and a post-implementation group (n=51). We statistically compared the adherence rates to five key components of the institutional SAB management guideline and the 30-day mortality between the two groups. The proportion of cases that received initial AST pharmacist intervention increased significantly from 6.6% in the pre-implementation group to 64.7% in the post-implementation group. The median time from positive blood culture to intervention was significantly reduced from 2.5 days in the pre-implementation group to 1 day in the post-implementation group. Adherence to four or more guideline components increased significantly from 30.0% in the pre-implementation group to 72.5% in the post-implementation group. Significant improvements were observed in repeat sample collections for blood culture (14.8% vs. 62.7%), echocardiography (78.7% vs. 98.0%), appropriate antimicrobial therapy (36.1% vs. 56.9%), and appropriate treatment duration (64.6% vs. 87.5%) in the post-implementation group as compared with the pre-implementation group. Adherence to source control improved from 63.6% in the pre-implementation group to 89.5% in the post-implementation group, although the difference was not statistically significant. The 30-day mortality rate decreased from 18.3% in the pre-implementation group to 7.8% in the post-implementation group, although this difference also did not reach statistical significance. A template-based AST pharmacist-led intervention was associated with earlier intervention and an improved adherence rate to evidence-based SAB treatment. This approach may be useful in healthcare settings with limited availability of infectious disease physicians.

Key word

Staphylococcus aureus, bacteremia, antimicrobial stewardship team

Received

February 9, 2026

Accepted

April 30, 2026

Jpn. J. Chemother. 74 (4): 492-501, 2026