Clinical Pharmacy Practice Research Articles

The International Collaboration of Pharmacy Journal Editors (ICPJE) formally constituted to foster quality around clinical and social pharmacy practice research publications

The Granada statements were a result of the need to strengthen clinical, social and administrative pharmacy practice as an area of knowledge that translates into practice, research and policy. As a re-sponse, a group of clinical and social pharmacy practice journal editors launched an initiative in Grana-da in 2022 to discuss ways to improve the quality of publications in this area, which culminated in the Granada statements. Eighteen statements were developed, clustered into six main domains:1) the ap-propriate use of terminology; 2) developing impactful abstracts; 3) having the required peer reviews; 4) preventing journal scattering; 5) more effective and wiser use of journal and article performance met-rics; and 6) authors' selection of the most appropriate pharmacy practice journal to submit their work.The full Granada statements have been published in 14 journals.(1-14) These pioneering statements are rooted in similar endeavors undertaken by scholars in other health professions groups, fostering the concept of interdisciplinary consensus and advancing scientific paradigm.

An exploration of clinical pharmacy practices in Lao PDR: a national survey of hospital pharmacists.

To explore clinical pharmacy practice among hospital pharmacists in the Lao People's Democratic Republic (Lao PDR). A cross-sectional study was conducted in 158 hospitals of Lao PDR, surveying hospital pharmacists involved in patient care from January to March 2022. The number of pharmacists providing clinical pharmacy and their practice frequency were assessed. Differences across pharmacist characteristics, hospitals, and areas were examined. One hundred thirty-nine hospital pharmacists completed the questionnaire, a response rate of 87.9%. The number of hospital pharmacists per 100,000 population was highest in Xaisomboun and lowest in Savannakhet. The number of pharmacists per 1,000 km² was highest in Vientiane prefecture, and very low in many provinces. Only 12 (1.3%) pharmacists reported training in clinical pharmacy. The most prevalent activities were evaluating drug therapy (96.4%), upholding professionalism (96.4%), and committing professionalism (94.9%). The least prevalent were locating evidence (56.8%), applying knowledge (58.9%), and demonstrating continuing professional development (59.7%). Differences in practices were noted between age, qualification, and hospital types. Current major activities included rational drug use, antibiotic stewardship, and managing adverse drug reactions. Future expectations included diabetes, human immunodeficiency virus, and tuberculosis clinics. Clinical pharmacy services like patient care and pharmacotherapy management are frequently provided, but there is a shortage of trained clinical pharmacists and variability in practices between hospitals and regions. Technical support, training programmes, and a clinical pharmacy framework are needed in Lao PDR.

Impact of Hybrid Care in Pharmacist-Led Diabetes Clinics on Hemoglobin A1c.

Background: During the coronavirus disease 2019 (COVID-19) pandemic, many clinical practices shifted to using virtual platforms to care for patients. After in-person visits resumed, many patients continued to participate in virtual care. Objective: This study evaluated the impact of hybrid care (virtual and in-person visits) on diabetes control in patients seen by clinical pharmacists operating under collaborative drug therapy management (CDTM). Methods: A retrospective chart review was completed for adult (18+) patients with type 2 diabetes (T2D) managed under CDTM protocols in clinical pharmacy ambulatory care clinics. Patients were included if they were discharged between January 2018 to December 2019 (pre-video) or January 2022 to December 2023 (post-video) and had documented baseline and post-intervention hemoglobin A1c (HgbA1c) values. Results: Of the 528 patients that met the inclusion/exclusion criteria, 290 were in the pre-video group and 238 were in the post-video group. There was a non-statistically significant trend toward a greater average decline in HgbA1c in the post-video period (-1.7) compared with the pre-video period (-1.5) (P = 0.239). Secondary outcomes showed the percentage of no-show appointments to be less in the post-video group (7.1 vs 5.2; P = 0.0178) and the mean number of visits to be similar (6.4 vs 6.3; P = 0.5753). Conclusions: A hybrid visit-type model that incorporates video appointments into clinical pharmacy practice provided similar outcomes to traditional in-office/telephone visits. These results demonstrate the importance of ambulatory care pharmacists continuing to offer virtual visit types despite no longer being in a state of emergency.

52nd ESCP Symposium on Clinical Pharmacy. Implementing and scaling sustainable clinical pharmacy practice : 21-23 October 2024, Kraków, Poland.

52nd ESCP Symposium on Clinical Pharmacy. Implementing and scaling sustainable clinical pharmacy practice : 21-23 October 2024, Kraków, Poland.

Forecasting the impact of artificial intelligence on clinical pharmacy practice

AbstractThere is a need to understand contemporary scientific advances as clinical pharmacy evolves. One rapidly expanding area is artificial intelligence (AI), which has grown significantly over the past year because of the public availability of large language models. This commentary reviews published literature describing and evaluating applications of AI to each aspect of the medication use process and forecasts potential future roles for AI in pharmacy practice. Potential challenges in implementation are also described.

The International Collaboration of Pharmacy Journal Editors (ICPJE) formally constituted to foster quality around clinical and social pharmacy practice research publications.

The International Collaboration of Pharmacy Journal Editors (ICPJE) formally constituted to foster quality around clinical and social pharmacy practice research publications.

P-1806. ABLE to De-Label: Liberating Patients from Penicillin Chart Allergies

Abstract Background The Veterans Affairs Clinical Pharmacy Practice Office Allergy to Beta Lactam Evaluation (ABLE) initiative was launched at the at the Michael E DeBakey VA Medical Center in October 2023. The primary implementation tool was a standardized note template, streamlining the documentation and assessment of penicillin allergy information. Patients who had tolerated penicillins since reaction or had side effects were eligible for immediate de-labeling. Those with unknown reactions, IgE-mediated allergies >10 years ago, or non-severe IgE-mediated allergies >5 years ago were considered candidates for penicillin allergy testing. All other reactions were considered ineligible for further evaluation. Results of ABLE intervention Results of ABLE intervention from October 2023-February 2024 Methods Patients labeled as penicillin allergic who were previously seen in ID clinic were contacted via unscheduled telephone calls to clarify allergy histories, identify opportunities for de-labeling, and provide recommendations for alternative beta-lactam use. The primary outcome was the proportion of “penicillin-allergic” patients successfully de-labeled. ABLE Intervention Flowchart Results Of 88 patients identified, 16 (18%) were deceased and 13 (15%) were de-labeled prior to ABLE implementation in October 2023. 56 of the 59 remaining patients received at least one attempt at telephone contact. 24 patients received the ABLE intervention. Of these, 8 patients (33%) were immediately de-labeled, and 1 declined to have the allergy removed despite being eligible. Another 13 patients (54%) were eligible for further allergy testing, of which 5 (21%) accepted a referral to Allergy clinic. Two patients (8%) were not eligible for further testing. One patient who was successfully de-labeled regained the penicillin allergy label. Conclusion The ABLE initiative improves antimicrobial stewardship and patient care by accurately assessing and managing penicillin allergies. These findings suggest those who are eligible for immediate de-labeling based on chart review should be prioritized for intervention. However, based on the acceptance rate of this telephonic intervention, alternative modalities of implementation should be explored. Disclosures All Authors: No reported disclosures

Practice Guidelines for the Value Evaluation of Clinical Pharmacy Services (version 2).

To optimize the construction of pharmaceutical services in medical institutions, advance the development of clinical pharmacy as a discipline, enhance the level of clinical pharmacy services, systematically implement and evaluate clinical pharmacy practices, and improve patient therapeutic outcomes, we have developed the Practice Guidelines for the Value Evaluation of Clinical Pharmacy Services (Version 2). This guideline was designed following the World Health Organization (WHO) Guideline Development Manual. The Delphi method was employed to identify clinical questions. A comprehensive systematic search was conducted to collect existing evidence on relevant issues, and the systematic reviews, evidence grading, and evidence summaries were subsequently compiled. The guideline employs the Joanna Briggs Institute (JBI) evidence level system from Australia and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system introduced by WHO in 2004 to classify the quality of evidence. Consensus on the recommendations and evidence levels was achieved through the Delphi method, resulting in the formation of the Practice Guidelines for the Value Evaluation of Clinical Pharmacy Services (Version 2). Through a questionnaire survey of over 100 experts and the Delphi method voting, 23 preliminary indicators for evaluating the value of clinical pharmacy services were identified. The content of these included indicators was searched according to the PICO principle, followed by systematic reviews, meta-analyses, network meta-analyses, and related original research. Each search strategy was reviewed and approved by the guidelines steering committee. Ultimately, three dimensions for evaluating the value of clinical pharmacy were identified, encompassing 15 indicators, resulting in 20 recommendations. This guideline presents a set of metrics to assess the quality and effectiveness of clinical pharmacy services, which is crucial for enhancing and elevating clinical pharmacy services in healthcare institutions. http://www.guidelines-registry.org/guide/28502a74-7038-439c-bdee-d355747e2a9d, identifier: PREPARE-2022CN756.

Trends and considerations in the pursuit of postgraduate training: Motivations, barriers, and well-being.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Pharmacy residency training, endorsed by the American Society of Health-System Pharmacists (ASHP), is designed to enhance clinical pharmacy practice. However, in 2022 and subsequent years the ASHP Resident Matching Program reported unprecedented numbers of unfilled positions, notably in postgraduate year 2 (PGY2) programs. This review explores motivations, barriers, and well-being indices in pharmacy residency pursuit and training, seeking to explain the rise in unfilled postgraduate training positions. Two literature searches were performed using relevant resources and databases: search 1, to determine motivating factors and barriers to pursuit of postgraduate training; and search 2, to gather evidence related to resident well-being, burnout, and resiliency. Search 1 yielded 11 studies about motivating or deterring factors for pharmacy residency pursuit, whereas search 2 produced 16 articles on resident well-being. Major motivators for pursuing postgraduate training included the desire to gain knowledge and specialized training, recognition of evolving pharmacist roles, and viewing residency as a prerequisite for certain positions. Conversely, major barriers included financial or family obligations and concerns about job availability post graduation. Most articles discussed student pursuit of PGY1 residencies. Resident well-being encompassed burnout assessments, other wellness indicators like depression, and the impact of the coronavirus disease 2019 (COVID-19) pandemic. Developed well-being programs elicited mostly positive perceptions from pharmacy residents. There is a body of published literature elucidating motivations and barriers to the pursuit of postgraduate training and well-being related to wellness/satisfaction on the job. However, to comprehensively evaluate well-being program impact and address gaps in literature regarding barriers to and motivators for pursuit of specialized PGY2 programs, further research is needed.

The Pediatric Clinical Pharmacy Practice: From Basic Knowledge to Advanced Clinical Judgment

The Article Abstract is not available.

Exploring information technology utilization and needs in community pharmacies: a cross-sectional survey in Shanghai, China.

Community pharmacists are critical in managing medication therapy and ensuring patient safety. However, in many countries, including China, challenges such as limited access to real-time patient data, fragmented communication systems, and underdeveloped clinical decision-support tools hinder the effectiveness of pharmacy services. Integrating information technology (IT) into community pharmacies can improve medication management by providing timely access to patient information, enhancing medication safety, and facilitating communication with healthcare providers. This study aimed to explore the medication management practices of community pharmacists, the existing IT support available, and their specific requirements for IT-assisted medication management in community pharmacies in Shanghai, China. An online self-assessment survey was conducted to evaluate the utilization and needs of IT-based medication management among community pharmacists in Shanghai. Demographic data and information on pharmaceutical care practices were collected and analyzed to examine correlations between these factors and the need for IT support. 963 out of 2,178 surveys were completed over 6months. Nearly all respondents (99.3%) provided at least one type of pharmaceutical care, but only 0.93% offered all types. Regarding current utilization and needs for IT systems, community pharmacists rated access to patient/medication information and digital standardized documentation flow as poor satisfaction with the highest level of needs. Multivariate regression analysis showed that IT needs were significantly associated with time spent in clinical pharmacy practice, time dedicated exclusively to clinical pharmacy, and the number of prescriptions dispensed weekly. While community pharmacists are key in providing pharmaceutical care, IT support remains inadequate. There is a pressing need for an integrated IT system that offers real-time access to patient medical information, a standardized documentation system, improved clinical decision support software, and enhanced communication with other healthcare providers.

Benchmarking hospital clinical pharmacy practice using standardised key performance indicators (KPIs).

Background: Hospital pharmacy services support quality use of medicines and medication safety through clinical pharmacy activities such as medication reviews and patient education. These activities can be measured and monitored using evidence-based and standardised key performance indicators (KPIs), which highlight the value of pharmacy services. Standardisation of KPIs supports long-term benchmarking and inter- and intra-site comparisons to target key areas for improvement in clinical pharmacy services. Aim: To describe the type and frequency of clinical pharmacy activity across five hospitals within one metropolitan hospital district. Methods: Key Performance Indicator data were collected by pharmacists from five hospital sites at one metropolitan hospital district, in Queensland Australia. Data were collected over one week for the following clinical settings: inpatient, discharge, outpatient clinic, and the dispensary. Data were collected using a manual, paper-based data collection tool previously developed using a co-design process. Results: Across 11,215 inpatient encounters, hospital pharmacy services provided: best possible medication history (BPMH) within 24 h of admission: 69.5%; daily medication chart review: 57.2%; discharge education: 82.7%, discharge reconciliation: 88.2%; and provision of discharge medication record: 82.4%. Across 1,092 outpatient encounters, pharmacists documented BPMH for 33.3% of patients. Pharmacists identified a total of 5,009 drug-related problems (DRPs) across the data collection period, with the rate of identification highest in the outpatient clinic setting (64.8 per 100 patient reviews) followed by discharge (52.6 per 100 patient reviews) and then inpatient (48.1 per 100 patient reviews). Almost 20% of DRPs identified (n = 975) were high risk. Conclusion: Reporting and benchmarking clinical pharmacy activity through standardised KPIs supports opportunities to identify service improvements. Future research should focus on larger scale studies using routinely recorded data to monitor clinical pharmacy KPIs across all care settings.

The International Collaboration of Pharmacy Journal Editors (ICPJE) formally constituted to foster quality around clinical and social pharmacy practice research publications

The Granada statements were a result of the need to strengthen clinical, social and administrative pharmacy practiceas an area of knowledge that translates into practice, research and policy. As a response, a group of clinical and social pharmacy practice journal editors launched an initiative in Granada in 2022 to discuss ways to improve the quality of publications in this area, which culminated in the Granada statements. Eighteen statementswere developed, clustered into six main domains:1) the appropriate use of terminology; 2) developing impactful abstracts; 3) having the required peer reviews; 4) preventing journal scattering; 5) more effective and wiser use of journal and article performance metrics; and 6)authors' selection of the most appropriate pharmacy practice journal to submit their work. The full Granada statements have been published in 14 journals. [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] These pioneering statements are rooted in similar endeavors undertaken by scholars in other health professions groups, fostering the concept of interdisciplinary consensus and advancing scientific paradigm. 15, 16 Various chief editors, associated editors, and publishers met again in June 2024, this time in Basel, Switzerland. Following a consensus approach to select a name that best reflected the group scope, mission and vision, the name of the International Collaboration of Pharmacy Journal Editors (ICPJE) was selected. The ICPJE was then born. During the meeting in Basel, the group discussed current issues relating to raising the quality of publications which among other things reflected a need to abate the discipline's need to re-evaluate itself though papers examining the importance of pharmacy by other stakeholders. These were not cited by papers outside or even within pharmacy, which has been demonstrated by a more holistic examination of drivers of citations through original research. 17 The findings of this study highlight four main factors associated with citations, the paper's number of references, the year of publication, social media mentions and ☆ This editorial is being co-published by all journals of the International Collaboration of Pharmacy Journal Editors.

Identifying disruptive papers in pharmacy literature that changed clinical practice: 1954-2014.

This study aimed to identify research publications that have significantly influenced clinical practice in pharmacy using a novel metric known as the disruption score. We conducted a bibliometric analysis and PubMed search of pharmacy practice articles published in 11 key pharmacy journals and articles tagged with the MeSH term "pharmacy" or "pharmacist." Utilizing a validated dataset of disruption scores encompassing articles published between 1954 and 2014, we identified the top 100 most disruptive papers alongside the top 100 most cited papers. Additionally, we explored comparisons between these lists and across various journals to gain comprehensive insights into the field's evolution over time. A total of 59,535 articles met the inclusion criteria, of which 56,764 (95%) were published in the 11 core pharmacy practice journals we chose while 2,771 (5%) were published in other PubMed-indexed journals. Notably, the top 100 most disruptive papers were deemed more disruptive than 99.9% of the entire PubMed universe. The most cited paper was the 22nd most disruptive paper. The mean citation count among the top 100 most disruptive papers was 196. The 1990s was the most disruptive decade, and American Journal of Health-System Pharmacy was the most disruptive journal. We observed a weak correlation between disruption score and citation count. The disruption score identified an innovative body of landmark papers whose legacy will remain solidified in pharmacy practice. The disruption score offers a unique perspective on clinical significance, complementing other bibliometric indices and adding to the identification of papers that have introduced new paradigms in pharmacy.

Neuromuscular monitoring: A tutorial for pharmacists.

To describe neuromuscular monitoring modalities and highlight the importance of neuromuscular monitoring to clinical pharmacy practice. A growing body of literature and clinical practice guidelines have highlighted the importance of neuromuscular monitoring practices to ensure patient safety during surgery and in the intensive care unit. Understanding neuromuscular monitoring modalities can allow pharmacists to enhance participation in institutional discussions and optimization of neuromuscular blocker administration and reversal practices. We have described the various modalities of neuromuscular monitoring and considerations for using different modalities. Neuromuscular monitoring should be performed whenever neuromuscular blocking agents are administered. This practice represents an evidence-based approach to minimizing the occurrence of residual neuromuscular blockade and its associated complications.

Addressing the second victim phenomenon among community pharmacists and its impact on clinical pharmacy practice: a consensus study.

The second victim phenomenon, denoting the harmful effects of patient safety incidents on healthcare practitioners, remains insufficiently examined within the pharmacy workforce. This study aimed to investigate the second victim phenomenon in community pharmacies, focusing on its triggers, impacts on pharmacists' well-being, and effects on pharmaceutical care and safety. This consensus study with the Nominal Group Technique involved 27 community pharmacists in three equal groups. The final ranks of the statements scored by participants from 5 to 1 were recalculated using the Van Breda method, combining three distinct data sets with higher values for a higher impact on the output evaluated. Statistics were applied to ascertain event distribution and investigate the potential relationships between event categories and outcomes for patients and pharmacists. "Patient-centric anxiety" (6.8) was the top mental health issue, followed by "Personal responsibility and resilience" and "Future concerns and career aspirations" (6.0 each). The dominant support was "Colleague/Peer support" (5.3). The most frequent patient safety incidents were "Inadequate pharmaceutical service" (8.0) and "Wrong drug dispensed" (7.8). Most errors (63%) were dispensing failures, primarily wrong drug dispensed (44.4%). Of these, 50% were near misses, 25.0% caused no harm, and 16.7% had serious consequences. Field notes suggest contributing factors like inadequate supervision, crowding, and storage issues. This study revealed the second victim phenomenon among pharmacists, which potentially stems from breaches in practice standards. The impact on the quality and safety of pharmaceutical care and its influence on pharmacists' well-being should be studied in further studies.

Sentiment analysis in medication adherence: using ruled-based and artificial intelligence-driven algorithms to understand patient medication experiences.

Studies are exploring ways to improve medication adherence, with sentiment analysis (SA) being an underutilized innovation in pharmacy. This technique uses artificial intelligence (AI) and natural language processing to assess text for underlying feelings and emotions. This study aimed to evaluate the use of two SA models, Valence Aware Dictionary for Sentiment Reasoning (VADER) and Emotion English DistilRoBERTa-base (DistilRoBERTa), for the identification of patients' sentiments and emotions towards their pharmacotherapy. A dataset containing 320,095 anonymized patients' reports of experiences with their medication was used. VADER assessed sentiment polarity on a scale from - 1 (negative) to + 1 (positive). DistilRoBERTa classified emotions into seven categories: anger, disgust, fear, joy, neutral, sadness, and surprise. Performance metrics for the models were obtained using the sklearn.metrics module of scikit-learn in Python. VADER demonstrated an overall accuracy of 0.70. For negative sentiments, it achieved a precision of 0.68, recall of 0.80, and an F1-score of 0.73, while for positive sentiments, it had a precision of 0.73, recall of 0.59, and an F1-score of 0.65. The AUC for the ROC curve was 0.90. DistilRoBERTa analysis showed that higher ratings for medication effectiveness, ease of use, and satisfaction corresponded with more positive emotional responses. These results were consistent with VADER's sentiment analysis, confirming the reliability of both models. VADER and DistilRoBERTa effectively analyzed patients' sentiments towards pharmacotherapy, providing valuable information. These findings encourage studies of SA in clinical pharmacy practice, paving the way for more personalized and effective patient care strategies.

Study on the Management of Diabetic Foot Ulcer in Diabetic Patients at a Tertiary Care Hospital

AIM: To study the treatment pattern of diabetic foot ulcer and to assess the effect of patient counselling on diabetic foot ulcer patients. OBJECTIVE: 1. To study the various modalities of treatment used for Diabetic Foot Ulcer patients in a tertiary care hospital. 2. To assess the effect of patient counselling on diabetic foot ulcer patients with standard questionaries METHODS: The protocol was reviewed, revised, and approved by the Institutional Review Committee of MVJ Medical College and Research Hospital before commencement of the study. Over the course of six months, a tertiary care hospital conducted prospective research. Following the giving of written informed permission, diabetic patients with foot ulcers of both genders who were visiting the hospital were invited to participate and enrolled. A total of 150 patients participated in the study. The patients were recruited according to the inclusion and exclusion criteria mentioned. The study was attempted to improve the patient’s knowledge and attitude towards the self-management of diabetic foot ulcer. And thus, patient counselling is an essential component of clinical pharmacy practice in hospital. RESULTS: In this study, majority of the study participants belonged to the age group 61-70 years (30.7%) of age. 22% of the study participants were of the age group between 51-60 years of age. Majority (64.7%) of the study participants were males. In this study, Nottingham Assessment of Functional Footcare (Revised 2015) was used and an improvement in the total score was found i.e., from 18.27+5.85 before counselling jym oof ff\c b to 44.07+4.70 post counselling which was found to be statistically significant (P<0.001). Thus, a proper foot care education program has been shown to reduce the risk of ulceration. CONCLUSION: The present study was conducted to study the effect of patient counselling on diabetic foot ulcer patients using NAFFC score. Majority in the study belonged to 61-70 years and were males. Most of them had type 2 DM and grade 1 foot ulcer. In this study, Nottingham Assessment of Functional Footcare (Revised 2015) was used and an improvement in the total score was found i.e., from 18.27+5.85 before counselling to 44.07+4.70 post counselling which was found to be statistically significant (P<0.001). NAFFC score played an important role in the study to assess the functional outcome among diabetics with foot ulcers. Though there is development of new therapies for the management of diabetic foot ulcers, a high rate of failure ending with amputation still exists. Hence a counselling session to the diabetics with foot ulcers can prevent further complications.

Medication reconciliation enhances the accuracy of gastric emptying scintigraphy

BackgroundGastroparesis (GP) is a prevalent sensorimotor disorder characterized by delayed gastric emptying without mechanical obstruction, posing significant diagnostic challenges. Gastric emptying scintigraphy (GES) is the gold standard for diagnosing GP. However, its accuracy can be compromised by many medications that affect gastric motility. This study evaluates the impact of medication reconciliation on the diagnostic accuracy of GES.ResultsA significant proportion of patients (75%) were on medications known to affect gastric motility. Recommendations for medication adjustments were communicated, with 30% non-adherence. Adjustments in GES interpretations were necessary for 20% of patients following comprehensive medication reviews. The involvement of radiopharmacists facilitated accurate diagnostic conclusions, underscoring the critical role of medication reconciliation in GES accuracy.ConclusionMedication reconciliation enhanced the accuracy of GES in diagnosing gastroparesis, emphasizing the need to integrate clinical pharmacy practices into nuclear medicine. This interdisciplinary approach not only improves diagnostic accuracy but also enhances patient safety, advocating for the adoption of such practices in the management of gastroparesis.

Prevalence of inappropriate antibiotic doses among pediatric patients of inpatient, outpatient, and emergency care units in Bangladesh: A cross-sectional study.

The heterogeneous pediatric populations, their physiological differences, along with the necessity of performing additional dose calculation, make the pediatric population more vulnerable to the incidences of inappropriate antibiotic doses. This study was conducted to examine and evaluate the appropriateness of antibiotic doses. A cross-sectional study with a quantitative approach was conducted in three hospitals located in Savar from January 06, 2021 to October 17, 2022. This study had used a convenient sampling method to collect 405 filled prescription orders from heterogeneous pediatric patients prescribed by physicians from emergency, inpatient, and outpatient care units of various clinical settings. The Harriet Lane Handbook was used as reference to investigate inappropriate doses of antibiotics. Subsequently, all analyses were conducted using the RStudio 1.3.959 software. Binary logistic regression was used to assess the risk of inappropriate antibiotic prescription in pediatrics. The overall prevalence of inappropriate antibiotic dosing in pediatrics was 335 out of 545 (61.5%). Overdosing (36.3%) and oral antibiotic prescriptions (64%) were more common than underdosing (20.4%) and parenteral antibiotics (36%). The majority (230 out of 405, 56.8%) of pediatric patients had prescriptions with inappropriate antibiotic doses, with prevalence rates of 33.8% for inpatients, 86.7% for outpatients, and 50% for emergency pediatrics. The results also indicated that pediatric patients in outdoor and emergency care units, infants, toddlers, and early childhood, those prescribed two antibiotics simultaneously, and those receiving parenteral antibiotics, were less likely to have inappropriate antibiotic dosages in their prescriptions. This study demonstrated that about one out of every two prescriptions had inappropriate antibiotic doses; in particular, prescriptions containing only one antibiotic exhibited a substantial proportion of inappropriate antibiotic doses. Inappropriate antibiotic doses may result in therapeutic failure, patient harm, and antibiotic resistance. Good clinical pharmacy practice and careful adherence to pediatric dosing standards may minimize inappropriate antibiotic doses.