A prospective study on the practice of antibiotic escalation and de escalation in tertiary care hospital

Srinath M M

doi:10.36948/ijfmr.2025.v07i06.63981

A prospective study on the practice of antibiotic escalation and de escalation in tertiary care hospital

Author(s)	Mr. Srinath M M
Country	India
Abstract	Antibiotics have revolutionized the management of bacterial infections; however, their inappropriate and excessive use has accelerated the emergence of antimicrobial resistance, posing a major challenge to modern healthcare. In this context, the abstract describes a prospective observational study conducted in a tertiary care hospital to evaluate patterns of antibiotic escalation and de escalation and their associated clinical outcomes. The study design, setting, duration, and patient population are clearly defined, providing a strong methodological foundation. Data collection encompassed demographic details, clinical characteristics, microbiological findings, antibiotic prescribing patterns, and treatment modifications, allowing a comprehensive assessment of antibiotic use. The results indicate that both escalation and de-escalation strategies were actively practiced, with escalation occurring slightly more frequently. The predominance of elderly patients and the high burden of comorbidities reflect real-world inpatient scenarios. Broad-spectrum antibiotics were commonly used as empirical therapy, particularly piperacillin–tazobactam and meropenem, highlighting the need for prompt treatment in critically ill patients. Subsequent modification of therapy based on culture and sensitivity results demonstrates adherence to antimicrobial stewardship principles. The predominance of Gram-negative organisms, especially Escherichia coli and Klebsiella pneumoniae, underscores the importance of continuous surveillance of local resistance patterns. Hospital stay duration and the frequent use of concomitant medications further contextualize clinical decision-making. Overall, the abstract effectively integrates background, methodology, results and conclusions, emphasizing the role of culture-guided therapy, rational antibiotic use and stewardship interventions in optimizing patient outcomes and limiting the progression of antimicrobial resistance in tertiary care hospital settings.
Keywords	Keywords Antibiotic escalation; Antibiotic de-escalation; Antimicrobial stewardship; Antimicrobial resistance; Tertiary care hospital; Empirical therapy; Culture and sensitivity; Gram-negative bacteria; Rational antibiotic use.
Field	Medical / Pharmacy
Published In	Volume 7, Issue 6, November-December 2025
Published On	2025-12-28
DOI	https://doi.org/10.36948/ijfmr.2025.v07i06.63981

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A prospective study on the practice of antibiotic escalation and de escalation in tertiary care hospital

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