Defining Appropriate Antibiotics

Scoping review argues for clearer definitions of appropriate antibiotic therapy in clinical research

By
mdspire news news staff
February 10, 2026
4 min

MDSpire News

Objective:

To examine how appropriate antibiotic therapy (AAT) is defined in clinical research and its impact on patient outcomes, particularly in the context of modern antimicrobial stewardship.

Approach:

Key Findings:

98.6% of studies provided a definition of AAT, but definitions varied widely.
41% of empiric therapy definitions relied solely on in vitro susceptibility.
Definite therapy definitions showed 32% reliance on in vitro susceptibility alone.
Empiric AAT was associated with improved outcomes in 63% of analyses; definite AAT in 81%.
Inclusion of minimum treatment duration in definitions correlated with reduced mortality.
Most studies reported outcomes such as mortality, length of stay, and clinical failure.

Interpretation:

Definitions of AAT often lack comprehensive criteria, potentially overlooking important stewardship aspects and leading to variability in outcomes, which can affect clinical practice.

Limitations:

Many studies did not adjust for confounding factors, with one-third lacking multivariable analyses.
Guideline adherence was included in fewer than 5% of definitions, which may impact study outcomes.

Conclusion:

Standardized, multidimensional definitions of AAT are essential for improving comparability across studies and understanding the impact of antibiotic prescribing on patient outcomes, incorporating clinical, pharmacologic, and stewardship-based criteria.