The Impact of Clinical Microbiologists’ Interpretations and Therapeutic Recommendations Regarding Culture Test and Antibiotic Susceptibility Test Results on Antibiotic Management in Hospitalized Patients with Infections: A Systematic Literature Review
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Antimicrobial resistance (AMR) is one of the most pressing global public health threats of the 21st century, driving healthcare systems to implement robust antimicrobial stewardship programs (ASPs) in hospital settings. Clinical microbiologists contribute directly to these programs by generating interpretive comments, applying selective or cascade susceptibility reporting, and offering real-time therapeutic consultations based on culture and antibiotic susceptibility test (AST) results. This research aimed to systematically review the evidence on the impact of clinical microbiologists' interpretations and therapeutic recommendations on antibiotic management for hospitalized patients with infections. A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Three databases SciSpace, Google Scholar, and PubMed were searched, yielding 1,338 records; after deduplication and two-stage screening, 55 studies met the inclusion criteria. Three intervention types were identified: interpretive comments and nudges (n?=?28), selective or cascade reporting (n?=?21), and real-time microbiology consultation services (n?=?6). Microbiology-based interventions consistently improved antibiotic stewardship outcomes: appropriate antibiotic selection ranged from 47–92%, de-escalation rates from 19–67%, broad-spectrum antibiotic use was reduced by a median of 3–5 days, and time to optimal therapy was shortened by 20–43 hours. Clinical outcomes including mortality and length of hospital stay showed no significant differences. These findings demonstrate that microbiology-based stewardship interventions are clinically effective and safe, supporting their integration into routine hospital laboratory workflows.
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