Rationale: Antibiotic de-escalation involves adjusting treatment by switching from broad- to narrow-spectrum antibiotics when appropriate, transitioning from intravenous to oral administration, and tailoring treatment duration to evidence-based recommendations. Antibiotic therapy should also be discontinued if an infection is determined to be viral.
Microbiological test results are essential for guiding de-escalation. Samples must be collected correctly, at the right time, using appropriate equipment, and based on clear clinical indications. Proper handling and transport to the laboratory increase the likelihood of obtaining accurate and useful results. Antibiotic therapy should be adjusted accordingly once test results are available. Norwegian guidelines recommend using the narrowest effective antibiotic, particularly for urinary tract infections and lower respiratory tract infections, which are common in both primary and specialized healthcare settings.
References
- Helsedirektoratet. Retningslinje: Antibiotika i sykehus. https://helsedirektoratet.no/retningslinjer/antibiotika-i-sykehus
- Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis. 2016 May 15;62(10):e51-77. doi: 10.1093/cid/ciw118. Epub 2016 Apr 13