Scoring Toward Stewardship: APACHE and CURB-65 in De-escalating Antibiotics for Respiratory Tract Infections

Antibiotic de-escalation is an important part of antimicrobial stewardship programmes (ASPs), whereby the provision of effective initial antibiotic treatment is achieved while avoiding unnecessary antibiotic use that would promote the development of resistance. In this study, the average time to first de-escalate antibiotics in respiratory tract infections was assessed based on APACHE-II score, CURB-65 score. The APACHE (Acute Physiology and Chronic Health Evaluation) and CURB-65 (Confusion, Urea, Respiratory rate, Blood pressure, Age ≥65) scoring systems are vital tools in assessing the severity of Respiratory Tract Infections (RTI’s), particularly in hospitalized patients. By stratifying patients based on disease severity, these scores help clinicians make informed decisions about initiating, continuing, or de-escalating antibiotic therapy and promote antibiotic stewardship.