European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026
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.
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Hernández Silvia, Colomina Javier, Giménez Estela, Medina Andrea, Villarruel Katherine, Albert Eliseo, Navarro David, Torres Ignacio
Аннотация
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.
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.