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Purpose <p>Timely knowledge of local epidemiology is essential for guiding appropriate antibiotic therapy in severe infections such as bloodstream infections (BSI). In 2024, we developed “eBIMIC”, a web-based application that enables real-time parameterized consultation of cumulative antimicrobial susceptibility data base on demographic and microbiological parameters. Avaliable to all clinicians within the Clínico-Malvarrosa Health Department (Valencia, Spain). This study evaluated its potential impact on optimizing antibiotic therapy in BSI patients admitted from the Emergency Department (ED).</p> Methods <p>We retrospectively analyzed 212 adult patients with positive blood cultures from the ED between January and December 2023. Empirical and semi-targeted treatments were compared with eBIMIC-based susceptibility data using patient sex, age, ED location, and Gram stain results (for empirical therapy), or species identification (for semi-targeted therapy). A susceptibility rate ≥ 85% was considered optimal. Potential for antibiotic de-escalation was also evaluated.</p> Results <p>Empirical therapy was adequate in 85% of cases, and eBIMIC correctly predicted optimal coverage in 74.4% of them. Among inadequate treatments, eBIMIC successfully identified 78.1% as suboptimal. Concordance with semi-targeted therapy was high (92.6%). eBIMIC also revealed opportunities for safe de-escalation in 86% of patients receiving high-impact antibiotics. Retrospective simulation confirmed that eBIMIC would have recommended at least one effective empirical option in 99.5% of cases and matched in vitro susceptibility patterns in 92.9% of semi-targeted therapies.</p> Conclusion <p>eBIMIC is a mobile-accessible platform that integrates real-time microbiological data with demographic parameters to support individualized antibiotic selection and de-escalation. Its implementation has the potential to enhance antimicrobial stewardship by promoting timely, evidence-based therapeutic decisions in routine clinical settings.</p>

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eBIMIC: development of a web platform for real-time access to cumulative antimicrobial susceptibility reports and its potential impact on evidence-based antibiotic prescribing in bacteremia

  • 期刊论文

  • 发表日期：

    2026年1月20日

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  • Silvia Hernández,
  • Javier Colomina,
  • Estela Giménez,
  • Andrea Medina,
  • Katherine Villarruel,
  • Eliseo Albert,
  • David Navarro,
  • Ignacio Torres

摘要

Purpose

Timely knowledge of local epidemiology is essential for guiding appropriate antibiotic therapy in severe infections such as bloodstream infections (BSI). In 2024, we developed “eBIMIC”, a web-based application that enables real-time parameterized consultation of cumulative antimicrobial susceptibility data base on demographic and microbiological parameters. Avaliable to all clinicians within the Clínico-Malvarrosa Health Department (Valencia, Spain). This study evaluated its potential impact on optimizing antibiotic therapy in BSI patients admitted from the Emergency Department (ED).

Methods

We retrospectively analyzed 212 adult patients with positive blood cultures from the ED between January and December 2023. Empirical and semi-targeted treatments were compared with eBIMIC-based susceptibility data using patient sex, age, ED location, and Gram stain results (for empirical therapy), or species identification (for semi-targeted therapy). A susceptibility rate ≥ 85% was considered optimal. Potential for antibiotic de-escalation was also evaluated.

Results

Empirical therapy was adequate in 85% of cases, and eBIMIC correctly predicted optimal coverage in 74.4% of them. Among inadequate treatments, eBIMIC successfully identified 78.1% as suboptimal. Concordance with semi-targeted therapy was high (92.6%). eBIMIC also revealed opportunities for safe de-escalation in 86% of patients receiving high-impact antibiotics. Retrospective simulation confirmed that eBIMIC would have recommended at least one effective empirical option in 99.5% of cases and matched in vitro susceptibility patterns in 92.9% of semi-targeted therapies.

Conclusion

eBIMIC is a mobile-accessible platform that integrates real-time microbiological data with demographic parameters to support individualized antibiotic selection and de-escalation. Its implementation has the potential to enhance antimicrobial stewardship by promoting timely, evidence-based therapeutic decisions in routine clinical settings.