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Updated: Sep 1, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
A pharmacist-led, workplace-based educational intervention informed by behavioral science to influence antimicrobial
Koji Masuda1, Harumi Gomi2,3,4, Junko Tanuma4
1Department of Infection Control and Prevention, International University of Health and Welfare Narita Hospital, Narita, Japan. masuda.ko@jihs.go.jp.
Purpose:
Changing antimicrobial prescribing behavior is a key challenge in antimicrobial stewardship (AMS). In postgraduate clinical education, knowledge-based teaching alone is often insufficient to achieve sustained behavior change, highlighting the need for workplace-based educational designs informed by behavioral science.
Methods:
We conducted a retrospective before-after study to evaluate a pharmacist-led educational intervention designed to influence prescribing behavior of piperacillin/tazobactam (TZP) in Japan. The educational component, consisting of a pharmacist-developed video and post-test, was completed once by physicians prior to implementation, whereas a structured prescription rationale requirement was applied at each TZP prescribing event. Prescribing behavior was assessed using days of therapy (DOT) and antibiotic use density (AUD) over 6 months before and after the intervention. Educational components were treated as process indicators of engagement rather than primary outcomes.
Results:
All full-time physicians completed the instructional video and the post-test. Following the intervention, TZP use decreased by 22.3% in DOT, with consistent reductions observed in season-matched comparisons. Similar trends were observed for AUD.
Conclusion:
Workflow-embedded reflective prompts may be useful as a workplace-based educational strategy for influencing antimicrobial prescribing behavior.
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