Acute sinusitis is common in general practice. Although typically self-limiting, antibiotics are frequently prescribed despite guideline recommendations to restrict use. It remains unclear whether antibiotic treatment reduces subsequent health care use or work absence. To assess how initial treatment with or without antibiotics for acute sinusitis is associated with subsequent health care use and work absence, and to compare phenoxymethylpenicillin (PcV) versus other antibiotics. Nationwide registry-based observational cohort study of adults with acute sinusitis (ICPC-2: R75) diagnosed in Norwegian general practice 2012-2019. We compared GP visits, Ear, Nose, and Throat (ENT) specialist visits, repeat antibiotic prescriptions, and sick leave days in antibiotic-treated and untreated episodes. We estimated adjusted differences in outcomes between groups using linear regression (daily outcomes) and negative binomial regression (weekly counts). We included 627 211 episodes from 413 449 patients. Antibiotics were prescribed in 59% of episodes; 53% received PcV. During the index week, antibiotic use was associated with 1.7 fewer GP visits, 0.1 fewer ENT visits, and 25.1 more sick leave days per 100 episodes. Corresponding figures for the following 4 weeks were: 0.9 fewer GP contacts, 10.7 fewer sick leave days, and 0.6 more antibiotic prescriptions. PcV was associated with slightly more GP visits and re-prescribing than other antibiotics. Acute sinusitis is followed by a short-term increase in health care use and work absence. Initial antibiotic use was associated with modest short-term differences, but no meaningful reduction in overall follow-up. Findings are consistent with recommendations for restrictive prescribing and narrow-spectrum use when appropriate.

Antibiotic resistance poses a significant global health threat, exacerbated by over-prescription of antibiotics, which often happens in primary care for respiratory tract infections (RTIs). Studies indicate that up to half of these prescriptions may be unnecessary. Little is known about how general practitioners' (GPs) remuneration schemes influence prescribing. GPs compensated via fee-for-service (FFS) and capitation (CAP) may face stronger incentives to prescribe antibiotics compared to salaried GPs, as prescriptions can signal quality, reduce consultation time, and aid patient retention - critical where reimbursements depend on consultations and list size. This study examines how GP remuneration influences antibiotic prescribing for RTIs using Norwegian register data. We utilized linked registry data (2015-2019) from the Control and Payment of Health Reimbursements Database (KUHR), National GP Registry, Norwegian Prescribed Drug Registry (NorPD), and Statistics Norway. We matched antibiotic prescriptions to patient-GP contacts for RTIs. The dataset covers regular GPs (mixed FFS/CAP or fixed salary) and locum GPs (FFS or salary). (1) probability of antibiotic prescription during RTI contacts; (2) probability of selecting non-phenoxymethylpenicillin (non-PcV). We used linear probability, logit, and probit models, controlling for GP, patient, contact, and practice attributes. To mitigate selection bias, we exploited within-GP variation among those who switched remuneration type during the study period. Regular FFS/CAP GPs had a 12-15% higher relative probability of prescribing antibiotics for RTIs than salaried GPs, especially at initial contacts. When prescribing, they were 9-11% more likely to choose non-PcV. Switchers analyses showed that FFS/CAP increased prescription rates by 14% and non-PcV choice by 8%. Among locums, we did not find any significant difference in overall prescription rates between FFS and salary, but FFS locums favoured non-PcV by 7%. Remuneration schemes may influence antibiotic prescribing behaviour. FFS/CAP is linked to higher prescription rates and broader-spectrum antibiotic use among regular GPs, likely due to patient retention and time-efficiency incentives. Policy interventions, such as monitoring of prescriptions depending on the remuneration type or adjustments to the remuneration scheme (e.g., antibiotic-related pay-for-performance), could promote prudent prescribing. Further research is needed on prescription appropriateness and quality impacts.

Antimicrobial resistance (AMR) has caused a global public health crisis, contributing to approximately five million deaths in 2019 and predicted deaths of approximately ten million annually by 2050. This equates to approximately 1.4-fold more deaths annually from AMR in 2050 than the entire COVID-19 pandemic to date. To tackle this AMR pandemic, regulatory and policy frameworks have been prepared at local, national and international levels with multi-faceted proposals and advances encompassing surveillance, diagnostics, infection prevention, antibiotic prescribing and variation of existing and novel treatment approaches. This narrative review primarily focuses on research and development which have been documented over the last five years in relation to therapeutic approaches at various stages in clinical development and the potential role that vaccines can play in the fight against AMR. This review provides an overview on antibacterial drugs, including novel classes of antibiotics, which have been recently approved, as well as combination antibiotic therapy and the potential of repurposed drugs. The potential role of novel antimicrobial, antibiofilm and quorum sensing inhibitors, such as antimicrobial peptides, nanomaterials and compounds from the extreme and natural environments, as well as ethnopharmacology including the antimicrobial effects of plants, spices, honey and venoms are explored. Novel therapeutic approaches are critically discussed in terms of their realistic clinical potential, detailing recent and ongoing trials to highlight the current interest of these approaches, including immunotherapy, bacteriophage therapy, antimicrobial photodynamic therapy (aPDT), antimicrobial sonodynamic therapy (aSDT), nitric oxide therapy and microbiome manipulation including faecal microbiota transplantation (FMT). The potential of predatory bacteria as living antimicrobial agents is also discussed. Importantly, there have been many technological developments which have enhanced bioprospecting and research and development of novel antimicrobials which this review draws attention to, including artificial intelligence, machine learning and Organ-on-a-Chip devices. Finally, key messages from the recent World Health Organization report into the role of vaccines against AMR provides an interesting perspective relating to prevention which can be of significance in tackling the AMR burden.

Background: Infective endocarditis (IE) is a severe and multifactorial condition historically linked to dental procedures. Current evidence shows that most cases arise from complex host–microbe interactions and biofilm colonization on damaged endothelium or intracardiac/prosthetic material, while the inappropriate use of antibiotics in dentistry promotes antimicrobial resistance. Objectives: To provide a narrative synthesis of contemporary evidence on (i) the relative contribution of dental procedures versus daily oral inflammatory burden to bacteremia and IE risk, (ii) the role of periodontal disease and the oral resistome in AMR, and (iii) the clinical and medico-legal implications of antibiotic prescribing and guideline adherence in dental practice. Materials and Methods: A narrative review was conducted using PubMed, Scopus, ResearchGate, and Google Scholar, complemented by manual screening of reference lists and relevant guideline documents. The search covered approximately the last decade (2015–2025) and included ESC 2023 and AHA 2021 guidance on IE prevention. Search terms combined concepts related to “infective endocarditis”, “antibiotic prophylaxis”, “dentistry/dental procedures”, “periodontitis/periodontal disease”, “bacteremia”, “biofilm”, “oral microbiome/oral resistome”, and “antimicrobial stewardship/antibiotic resistance”, using Boolean operators. Eligible sources included clinical studies, systematic reviews/meta-analyses, consensus statements and guidelines, and selected medico-legal literature relevant to dental decision-making and documentation. Editorials and non-peer-reviewed items without retrievable full text were not considered for evidence synthesis. Results: The reviewed evidence supports that spontaneous bacteremia associated with active periodontitis and daily oral activities may be more frequent than procedure-related bacteremia, suggesting that inflammation control and biofilm management represent a major preventive lever. Antibiotic prophylaxis should be reserved for a limited subset of high-risk cardiac patients as per contemporary ESC/AHA recommendations, whereas routine “defensive” prescribing in low-risk contexts provides minimal expected benefit and carries individual and societal harms (adverse events, microbiome disruption, AMR selection). Integrating periodontal care pathways with risk stratification and targeted antibiotic stewardship can improve patient safety and support public health. Conclusions: Dentistry plays a strategic preventive role in IE and AMR primarily through periodontal inflammation control, asepsis, and prudent antibiotic use. From a medico-legal standpoint, professional liability should be assessed on a process-based standard (risk assessment, adherence to updated guidelines, causal local treatment, informed consent, and traceable follow-up) rather than on outcome-driven hindsight.

The impact of antibiotics on childhood immunity has been a subject of significant research and ongoing debate in medical science. Antibiotics, while essential for treating bacterial infections and saving lives, have raised concerns regarding their potential influence on the developing immune system of children. This study explores the complex relationship between antibiotic use and immune development, highlighting both beneficial therapeutic effects and unintended negative consequences. The widespread prescription of antibiotics in childhood has contributed to the emergence of antibiotic-resistant bacteria, posing a serious public health challenge. Resistant infections are often harder to treat, resulting in longer illness durations and increased healthcare costs. Childhood represents a critical period for immune system development, during which early exposure to microorganisms helps shape immune responses later in life. Antibiotics can disrupt these natural microbial interactions by altering the composition of the gut microbiota, potentially reducing microbial diversity and affecting immune function. Such disruptions may increase susceptibility to allergies, infections, and immune-related disorders in later stages of life. To assess the impact of antibiotics on childhood immunity, the Weighted Aggregated Sum Product Assessment (WASPAS) method was applied. These multi-criteria decision-making approach assigns weights to relevant factors and aggregates scores to evaluate outcomes effectively. The analysis revealed variations among children, with Child 4 ranking highest in antibiotic impact on immunity, while Child 5 ranked lowest. These findings demonstrate individual differences in immune response and highlight the importance of cautious antibiotic use.

Abstract Background Antibiotic stewardship is critical to combating resistance. Our Quality Improvement Project (QIP) aimed to evaluate and enhance antibiotic prescribing practices across three DME wards by assessing guideline adherence, therapy duration, end date documentation, and concurrent proton pump inhibitor (PPI) use. Older adults are at higher risk of antibiotic associated complications, especially C. diff infection. Methods Baseline data were collected from the hospital’s electronic prescribing system, evaluating prescriptions for indication appropriateness, duration compliance, documentation of therapy end dates, and PPI co-prescription. An educational intervention (intervention 1: poster highlighting prescriber responsibilities, intervention 2: educational talk on the topic) was implemented, followed by repeat audits to measure impact. Data were analysed quantitatively using percentage adherence to metrics and qualitatively via prescriber feedback. Results After the first intervention, adherence to prescribing guidelines improved by 3%(65% to 68%), therapy end-date documentation increased by 9%(75% to 84%), and unjustified PPI co-prescriptions decreased by 7%(50% to 43%). Following the second intervention, adherence improved by an additional 4% (68% to 72%), therapy end-date documentation increased by 1% (84% to 85%), and unjustified PPI co-prescriptions decreased by 10% (43% to 33%). Conclusion Targeted educational interventions effectively improved antibiotic prescribing practices. Further cycles will focus on sustaining and building upon these improvements to optimise antimicrobial stewardship. Implications This QIP demonstrates the impact of simple, structured interventions in promoting responsible antibiotic use and reducing risks of resistance.

An estimated half a million UK primary care consultations are due to middle ear infections annually. In children, ear infections are one of the most common reasons for antibiotic use. To describe parents' experiences and actions for their child's ear infection symptoms. Online survey with parents of children aged 10 years or younger who had suspected ear infection symptoms in the previous 12 months in England. Data were collected retrospectively and through self-report. Multivariable logistic regression explored association of variables with consulting and reported prescription of antibiotics. 503 parents participated. Most parents perceived their child's symptoms as mild (25.8%) or moderate (64.6%). Consulting healthcare was the most reported action (90%); 74% consulted within 1-2 days. Perceived severity and duration of symptoms were associated with consulting. Parents were concerned about serious illness and the need for treatment. Other factors associated with consulting were missing work (AOR 4.8, 95% CI: 1.6 - 14.8), childcare impacts (AOR 3.1, 95% CI: 1.0 - 9.5) and fluid in child's ear (AOR 3.9, 95% CI: 1.48 - 10.5). Of consultors (454/503), 55.7% reported receiving an antibiotic. Of all parents (503), 36% believed children always require antibiotics for ear infections. Most parents consult for their child's ear infection symptoms and are prompted by impacts on daily life and perceptions of risk and treatment needs. There are knowledge gaps, which if addressed, may help to reduce primary care consultations and antibiotic use by supporting parents to manage self-limiting ear infections in children.

Inappropriate antibiotic use has become a significant driver of the global burden of antimicrobial resistance (AMR). Our study aims to identify the proportion and associated factors of inappropriate antibiotic use, including self-medication of antibiotics, and non-adherence to antibiotic prescriptions among Myanmar migrants in Thailand. A cross-sectional study was conducted among 348 Myanmar migrants from three Myanmar migrant communities in Samut Sakhon, Thailand. The sample was recruited using convenience sampling, and the survey was conducted using face-to-face interviews. The variables, including predisposing, reinforcing, and enabling factors based on the PRECEDE-PROCEED model, were constructed. Descriptive statistics, Chi-square or Fisher's Exact tests, and multiple logistic regression were performed to identify associated factors. The proportion of self-medication among all participants was 28.4% (n = 348), and non-adherence among migrants who took prescribed antibiotics was 67.5% (n = 249). Factors positively associated with antibiotic self-medication are; never visiting a hospital in Thailand (AOR = 3.54, 95% CI = 2.00-6.27), inability to recognize common antibiotic drugs in the photos (AOR = 2.80, 1.56-5.02), and lack of AMR information in the past year (AOR = 1.98, 1.04-3.76). Factors positively associated with non-adherence to antibiotic prescription includes alcohol drinking (AOR = 37.58, 4.55-310.63), moderate to severe legal status-related acculturative stress (AOR = 6.49, 2.10-20.05 for severe stress and AOR = 2.60, 1.20-5.68 for moderate stress), receiving information regarding antibiotic use (AOR = 2.79, 1.40-5.58), working 7 days per week (AOR = 2.36, 1.12-5.01), lack of health insurance (AOR = 2.20, 1.17-4.14) and proximity to a hospital (AOR = 2.22, 1.15-4.28). High levels of inappropriate antibiotic use among Myanmar migrants highlight the need to integrate migrants into Thailand's national action plan on AMR. The high prevalence of antibiotic misuse among Myanmar migrants highlights the need to include migrants in Thailand's national plan to combat antimicrobial resistance. To improve patient understanding and adherence to treatment, healthcare professionals should provide medication guidelines and education on the risks of antimicrobial resistance. Policymakers should focus future policies and interventions on providing interpretation services and establishing institutional mechanisms to ensure migrants' access to healthcare.

SUMMARYAntibiotic resistance is a major global health threat, with an estimated 1.14 million deaths in 2021 linked to antibiotic resistance. Mutations naturally arise as bacteria evolve to defend against and survive various environmental challenges, including those exerted by antibiotics. Both overuse and misuse of antibiotics can accelerate selection for resistant bacteria. Misuse can happen when antibiotic treatment ends prematurely, resulting in sub-lethal antibiotic levels. This provides an ideal environment for the proliferation of resistance-causing mutations, which, in some cases, are enhanced further by triggering the synthesis of error-prone DNA polymerases. Low levels of antibiotics are also found in the environment, creating breeding grounds for the evolution of antibiotic resistance. Mutations diminish the impact of antibiotics by three principal mechanisms: (i) reducing antibiotic influx, (ii) elevating antibiotic efflux, and (iii) altering cellular targets of antibiotics. The first two mechanisms confer modest resistance against a broad range of antibiotics; however, in combination with the third target-specific mechanism, they become the foundation of high-level antibiotic resistance. Ultimately, while the manifestation of mutations cannot be prevented, steps can be taken to lower their frequency by carefully considering the need for antibiotic prescription, exploring combination therapies, integrating adjuvants such as efflux pump inhibitors, and minimizing environmental contamination of antibiotics.

Penicillin Reintroduction Using the PEN-FAST Score Reduces Infectious Complications in Maxillofacial Surgery.

Dynamic shifts in outpatient antibiotic prescribing for pediatric upper respiratory infections in South Korea, 2002-2019: A national cohort study.

Evaluating the modified Centor criteria as a screening tool before polymerase chain reaction testing and antibiotic use for group A Streptococcus pharyngitis in a VA population.

Background and objective: Antibiotics are essential for the treatment of bacterial infections. Inappropriate antibiotic prescribing patterns lead to the development of increasingly resistant bacterial strains. One of the most effective methods to combat antibiotic resistance is the WHO Access, Watch, and Reverse (AWaRe) classification of antibiotics. The study was therefore an effort to determine whether there is any impact on increasing awareness of the WHO AWaRe antibiotic classification among third-year medical students who will become future doctors. Methods: Interventional study with an educational intervention was conducted in the Department of Pharmacology & Therapeutics, Gazi Medical College, Khulna, and Armed Forces Medical College, Dhaka, from April 2025 to November 2025. A total of 183 participants of 3rd year medical students were participated. The awareness of medical students on knowledge, attitude, and antibiotic prescribing perception was assessed and compared using a 10-item structured questionnaire. Results: Students who had not heard about the AWaRe classification of antibiotics in the pre-interventional phase were 80.9%, but the knowledge regarding the meaning and purpose of AWaRe classification of antibiotics increased from 6.6% to 44.3% after receiving the intervention. The percentage of students who agreed to follow the AWaRe classification of antibiotics in their future practice increased from 65.6% to 78.1%, and the percentage of students who agreed that the AWaRe classification of antibiotics can suggest safe choices of antibiotics increased from 47.5% to 64%. A significant increase (p <0.05) in knowledge, attitude, and perception score was found after educational intervention. Conclusion: This study revealed significant gaps in knowledge and attitudes towards AWaRe, emphasizing the necessity of increasing awareness amongst medical practitioners to promote rational use of antibiotics. Mediscope 2026;13(1): 08-15

Pneumonia is a leading cause of antibiotic use for children. This study aimed to assess nationwide antibiotic prescribing patterns for pediatric pneumonia in South Korea between 2016 and 2023, a period encompassing both epidemic and nonepidemic periods of Mycoplasma pneumoniae pneumonia (MPP). Using national claims data from the Health Insurance Review and Assessment Service, we analyzed antibiotic prescriptions for patients under 18 years diagnosed with bacterial pneumonia (International Classification of Diseases, 10th Revision codes; viral pneumonia was excluded). Antibiotic use was measured in days of therapy per 1000 patient-days (inpatients) or per 1000 patients (outpatients). Among 8.7 million inpatient days and 3.5 million outpatient visits, the 2-4 years group accounted for the highest burden (497.1 inpatient days and 161.6 outpatient visits per 1000 population). Macrolides were the most prescribed class in both inpatients [805.1 days of therapy (DOT)/1000 patient-days] and outpatients (4898.0 DOT/1000 patients), except in infants, where third-generation cephalosporins predominated. Use of third-generation cephalosporins increased sharply from 2022 and became the most prescribed class in 2023. Tertiary hospitals had higher use of tetracyclines (26.8 DOT/1000 patient-days) and quinolones but lower use of beta-lactams than other facility types. Antibiotic prescribing peaked in the fourth quarter of each year. Among children in South Korea diagnosed with bacterial pneumonia, macrolides were most frequently prescribed, and prescriptions for third-generation cephalosporins showed an increasing trend. These findings underscore challenges in antimicrobial stewardship and need for strengthened nationwide antimicrobial stewardship policies for pediatric pneumonia tailored to age, setting, and seasonal trends.

Antimicrobial stewardship (AMS) and infection prevention and control (IPC) programs are crucial for reducing antimicrobial resistance in hospitals. Existing quality indicators (QIs) for these programs are mainly qualitative, hindering external benchmarking. PILGRIM (NCT03765528) is a prospective multinational cohort study evaluating the impact of antibiotic prescription quality on intestinal domination by healthcare-associated pathogens. In this sub-study, we develop a quantitative scoring tool for AMS and IPC programs to facilitate standardized assessments of programs and support clinical studies. We used a RAND-modified Delphi consensus procedure to establish a scoring system for AMS and IPC programs. The tool was tested using data collected from eight hospitals in five countries during 2019-2024. We evaluated temporal associations between scores, Clostridioides difficile cases, hand disinfectant and antibiotic use. We assessed 98 QIs, resulting in in a final set of 62 QIs (35 for AMS and 27 for IPC). For our sites, the overall median score was 29 out of 50 (IQR 28-31) for AMS and 36 out of 50 (IQR 33-38) for IPC programs. Higher-scoring sites decrease antibiotic use over time. IPC scores were positively correlated with hand disinfectant use. This quantitative scoring scheme represents a promising step towards standardizing assessments of AMS and IPC programs in high-income settings, enabling external comparisons and supporting future clinical studies. Further validation is needed to refine its predictive validity and ensure its utility in diverse healthcare settings.

Impact of implementing repeated clinical audits and feedback on outpatient antibiotic prescribing in the pediatric emergency department of a French university hospital.

Antimicrobial resistance (AMR) is one of the highest critical issues causing global health in the 21st century, jeopardizing the chances of efficacy of antibiotics or any other form of antimicrobial agents. Microorganisms like bacteria, viruses, fungi, and parasites develop resistance to drugs that once efficiently cured the infection, making them difficult or even impossible to treat. This current phenomenon adds up to a grave public health problem that increases morbidity and mortality rates and healthcare costs all around the world. The WHO lists AMR among the ten topmost threats to global public health, thereby needing urgent coordinated efforts among governments, healthcare providers, and the public to curtail its spread. There are several actors in the rise of AMR; principally among them are overuse and misuse of antibiotics in human medicine and agriculture. In healthcare settings, unnecessary prescriptions for antibiotics are written for viral infections, which do not need antimicrobial treatment. Also, patients often do not complete their prescribed courses of antibiotics, allowing resistant strains to survive and multiply. According to a detailed report if current trends are allowed to continue, AMR could kill 10 million people annually by the year 2050, making it more deadly than cancer.

Fat grafting is commonly utilized to enhance outcomes in breast reconstruction. Despite their routine implementation, perioperative antibiotics lack sufficient evidence in reducing rates of surgical site infection (SSI). Leveraging the largest patient cohort to date, this study examines the association between perioperative antibiotics and SSI after fat grafting for breast reconstruction. The Epic Cosmos database (Verona, Wisconsin) was queried for patients who underwent fat grafting within one year following either implant-based or autologous breast reconstruction from January 2017 to January 2025. SSIs within 30 days were identified using either International Classification of Diseases (ICD) codes or identification of a new antibiotic prescription starting >7 days post-surgery. Perioperative antibiotics, age, body mass index (BMI), diabetes, smoking status, intraoperative intravenous antibiotics, and volume of fat grafted were included for multivariable regression. We analyzed 12,247 fat grafting procedures (8416 implant-based, 3831 autologous). In the implant-based cohort, perioperative antibiotics (OR, 1.21; P = 0.031), diabetes (OR, 1.65; P < 0.0001), higher BMI (OR, 1.02; P = 0.001), and younger age (OR, 0.99; P = 0.021) were significant risk factors for infection, defined by additional postoperative antibiotic prescriptions. For infections defined by ICD codes, only BMI was significantly associated with SSI (OR, 1.04; P = 0.001). In the autologous cohort, diabetes was the only significant risk factor for SSI (OR, 1.3; P = 0.033). Perioperative antibiotic prescriptions do not decrease SSI after fat grafting in either implant or autologous breast reconstruction patients. However, they are associated with increased additional postoperative antibiotic prescriptions in implant-based breast reconstruction patients. These data suggest reconsidering routine perioperative antibiotic prophylaxis and focusing on patient-specific risk factors.

Antimicrobial resistance (AMR) remains a global health priority, partly driven by non-guideline-concordant antibiotic prescribing among healthcare workers. Existing interventions often overlook the psychological and contextual factors that shape prescribing behaviour. This study integrated behavioural theory with explainable machine learning to identify psychological predictors of intention to use antimicrobials appropriately among clinicians. A cross-sectional survey was conducted among 1135 healthcare workers from four public hospitals in China. Participants completed questionnaires based on constructs from the Theory of Planned Behavior, the Health Belief Model, the Theory of Reasoned Action (TRA), Self-Efficacy Theory, Social Support Theory, and cognitive processing frameworks. LASSO regression and SHAP analysis were applied alongside machine-learning classifiers (e.g., XGBoost, LightGBM, CatBoost) to identify key predictors and interactions influencing intention to use antimicrobials appropriately. Social support, cognitive processing, knowledge and skills, and health beliefs were the most important predictors. SHAP analysis revealed nonlinear interactions, particularly between social support and cognitive processing. Ensemble models achieved high predictive accuracy (F1-scores > 0.94) for high and medium intention to use antimicrobials appropriately, whereas classifying low-intention respondents remained more challenging. Combining behavioural theory with explainable AI offers a scalable approach to identifying clinicians at risk of non-guideline-concordant prescribing. These findings support the development of psychologically tailored, real-time interventions to strengthen antibiotic stewardship and address AMR across diverse health-system settings.

BACKGROUNDInflammatory bowel disease (IBD) is a chronic, gastrointestinal condition including ulcerative colitis and Crohn’s disease. Patients diagnosed with IBD are more susceptible to infections and frequently require antibiotics.AIMTo analyze the antibiotic consumption of IBD inpatients and project future relevant trends.METHODSWe retrospectively collected the demographic and antibiotic usage data from the IBD patients hospitalized between 2015 and 2024. The antibiotics were classified, and the consumption intensity was calculated. The appropriate statistical methods were applied to compare the differences between groups. The Monte Carlo simulation was used to forecast the antibiotic consumption from 2025 to 2027.RESULTSA total of 1985 hospitalizations and 372 antibiotic prescriptions were included in this work. The antibiotic-exposed patients were older, had longer hospital stays, and higher costs. Males and ulcerative colitis patients showed a higher antibiotic usage. The highest consumption was observed in 2019, 2022, and 2024. The common indications were intestinal infections and perioperative prophylaxis. Cephalosporins and β-lactam antimicrobials were most commonly used, while carbapenems and glycopeptide antibacterials increased during 2022-2024. Although the antibiotic usage rates decreased in 2020-2024 when compared to 2015-2019, the consumption intensity significantly increased. The Monte Carlo simulation projected a 170.0% (95% uncertainty interval: -42.1% to 689.7%) consumption increase by 2027.CONCLUSIONThese findings highlight the need to strengthen antibiotic stewardship and infection control strategies in IBD inpatient management to prevent further escalation of antimicrobial resistance.