A team of ICU pharmacists is reviewing the antimicrobial use data for their hospital. They notice a significant increase in C. difficile infection rates over the past quarter, coinciding with an increase in meropenem and piperacillin-tazobactam use. Which antimicrobial stewardship intervention would be most effective in addressing this issue?

Question: A team of ICU pharmacists is reviewing the antimicrobial use data for their hospital. They notice a significant increase in C. difficile infection rates over the past quarter, coinciding with an increase in meropenem and piperacillin-tazobactam use. Which antimicrobial stewardship intervention would be most effective in addressing this issue?

Answer options:

• Implementing a mandatory ID consultation for all meropenem starts.
• Restricting antimicrobial use to formulary agents only.
• Initiating a 'bug-drug' mismatch report to identify inappropriate prescribing. ✅ Encouraging de-escalation of broad-spectrum antibiotics based on culture results.

Correct answer: Encouraging de-escalation of broad-spectrum antibiotics based on culture results.

Explanation: De-escalation of broad-spectrum antibiotics and reducing their duration of therapy are key strategies in antimicrobial stewardship to minimize collateral damage, such as C. difficile infections. Meropenem and piperacillin-tazobactam are broad-spectrum agents associated with a higher risk of C. difficile. Encouraging de-escalation based on culture results directly addresses the issue of unnecessary broad-spectrum coverage.