1052. Do Healthcare Providers De-Escalate β-Lactam (BL) Antibiotic Therapy Based on Results of Antibiotic Susceptibility Testing (AST)? Analysis of Bloodstream Infections (BSI) Caused by Escherichia coli and Klebsiella pneumoniae From the Veterans Health Administration (VHA)

摘要

BackgroundAchieving appropriate therapy for BSI caused by Gram-negative rods (GNR) is challenging. The availability of AST results allows de-escalation from broad- to narrow-spectrum agents. De-escalation is a goal of antimicrobial stewardship (AS). Through the analysis of inpatient BL antibiotic regimens in a nationwide cohort of patients with Escherichia coli and Klebsiella pneumoniae BSI, we compared the relative spectrum of empiric and definitive treatments to AST results and identified opportunities for de-escalation.