When antibiotics experts say no to antibiotics

Area of Science:

• Infectious Diseases
• Antimicrobial Stewardship

Background:

• Antibiotic resistance is a significant global health threat.
• Overuse and misuse of antibiotics contribute to the emergence of resistance.
• Judicious antibiotic prescribing is crucial for effective treatment and resistance mitigation.

Purpose of the Study:

• To present four clinical cases demonstrating unnecessary antibiotic initiation or continuation.
• To highlight the role of infectious diseases (ID) consultation in preventing antibiotic overuse.
• To emphasize the importance of accurate diagnosis and appropriate antibiotic stewardship.

Main Methods:

• Retrospective case review of four patients.
• Infectious Diseases (ID) service consultation and intervention.
• Analysis of clinical presentation, diagnostic workup, and treatment decisions.

Main Results:

• Case 1: Antibiotics stopped for asymptomatic bacteriuria after ID review.
• Case 2: Unnecessary antibiotics discontinued in a cholangiocarcinoma patient.
• Case 3: Antibiotics ceased for presumed pneumonia when viral etiology confirmed by ID.
• Case 4: Antibiotics not initiated for cough due to heart failure, avoiding unnecessary treatment.

Conclusions:

• These cases exemplify common instances of antibiotic overuse in clinical practice.
• Consultation with infectious diseases experts can prevent inappropriate antibiotic prescribing.
• Enhanced provider knowledge on antibiotic use and stewardship is essential.