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Article History

Received: 18 May 2023

Accepted: 30 August 2023

First Online: 16 September 2023

Declarations

:

: This study was approved by the Cleveland Clinic IRB (#21–863) and the AHRQ. The study is a low-risk quality-improvement initiative performed at the hospital level, making it impractical for patients to opt out of the study. We have study approval from the Cleveland Clinic Institutional Review Board for a waiver of informed consent. The interventions are considered minimal risk because physicians have the ability to override the orders for rapid diagnostic testing and pharmacist recommendations for de-escalation and final decisions will depend on the individual physician’s judgment. All participating providers will receive an information sheet about the study, including a description of measures for protecting confidentiality (Additional file ). Important modifications to the protocol are submitted to the Cleveland Clinic IRB and to ClinicalTrials.gov.

: Not applicable.

: AD has received research support from Seres Therapeutics and was a consultant for Merck, both unrelated to the current study. MK received royalties from UpToDate for chapters on hospital-acquired pneumonia. All other authors declare that they have no competing interests.