Impact of Pharmacist Led Multidisciplinary Deprescribing Strategy in Patients With Respiratory Tract Infections

This prospective, open-label, randomized controlled trial will evaluate the impact of a pharmacist-led multidisciplinary deprescribing strategy on azithromycin use in clinically stable adults aged 18-65 years with respiratory tract infections. A total of 200 participants will be randomly allocated in a 1:1 ratio to an intervention group or control group. The intervention group will receive pharmacist-led medication review and reassessment of azithromycin therapy, including dose optimization or discontinuation when appropriate, in collaboration with physicians. The control group will receive usual physician-directed care without a structured deprescribing intervention. Participants will be assessed at 48-72 hours and at the end of therapy. The primary outcomes will include appropriate azithromycin use, clinical cure, and treatment failure. Secondary outcomes will include adverse drug reactions, medication adherence, symptomatic improvement, and quality of life.

Inclusion Criteria: * Adults (18-65 years) with respiratory tract infections receiving azithromycin. * Patients receiving azithromycin either empirically or based on culture and sensitivity results. * Patients who are clinically stable and do not require ICU-level care at the time of inclusion Exclusion Criteria: * Patients falling outside the selected age group (below 18 years or above 65 years). * Patients receiving azithromycin who are not willing to participate in the study. * Pregnant or lactating women, as deprescribing or dose adjustment could lead to a risk. * Patients enrolled in other interventional studies that could affect azithromycin therapy or clinical outcomes.