Evaluating therapeutic appropriateness is a cornerstone of antimicrobial stewardship. The original Medication Assessment Tool for Community-Acquired Pneumonia (MAT-CAP), developed in Norway, requires adaptation to account for evolving IDSA/ATS recommendations and region-specific antimicrobial resistance patterns in the UAE. To revise, adapt, and validate a Medication Assessment Tool for Community-Acquired Pneumonia (rMAT-CAP), adapted to the UAE healthcare context. A methodological study was conducted in three phases: (1) systematic revision of MAT-CAP indicators in accordance with 2019 IDSA/ATS guidelines and UAE resistance data; (2) content validation through a multidisciplinary Delphi panel of 10 experts; and (3) psychometric validation using inter-rater reliability and criterion validity assessments based on 30 anonymized CAP cases. The rMAT-CAP comprised 13 explicit, guideline-aligned criteria covering empirical therapy, microbiological diagnostics, dose adjustment, IV-to-oral switch, and treatment duration. Content validity indices were excellent (mean I-CVI = 0.95; S-CVI/Ave = 0.95). Inter-rater reliability demonstrated almost perfect agreement for the drug domain (κ = 0.87; absolute agreement 90.0%, 95% CI: 73.5–97.9%), substantial agreement for the dose domain (κ = 0.64; absolute agreement 73.3%, 95% CI: 54.1–86.6%), and moderate agreement for the duration domain (κ = 0.45; absolute agreement 80.0%, 95% CI: 61.4–91.1%). Criterion validity showed strong diagnostic performance: sensitivity 100% (95% CI: 83.9–100%), specificity 62.5% (95% CI: 30.6–86.3%), PPV 88.0% (95% CI: 69.0–96.7%), NPV 100% (95% CI: 56.6–100%), and overall accuracy 90.0% (95% CI: 73.5–97.9%). The rMAT-CAP is a valid, reliable, and contextually relevant tool for evaluating therapeutic appropriateness in CAP management. Its structured approach supports antimicrobial stewardship initiatives and facilitates standardized audit and feedback in UAE hospitals. Clinical trial number: not applicable.
Elnajjar et al. (Sat,) studied this question.