Antibiotic Susceptibility Patterns of Bacterial Isolates from Routine Clinical Specimens: A Contemporary Analysis to Guide Empirical Antimicrobial Therapy to Address Antimicrobial Resistance

Abstract Introduction: Antimicrobial resistance (AMR) poses a critical challenge in global health, with a particularly severe impact in developing countries. The increasing resistance among bacterial pathogens complicates empirical therapy, especially in tertiary care settings. This study analyzed antimicrobial susceptibility patterns of bacterial isolates from a private tertiary care hospital in Srinagar, Jammu and Kashmir. Materials and Methods: A prospective observational study was conducted from June 2023 to December 2024. A total of 2101 clinical specimens were collected from outpatient department (OPD), inpatient department (IPD), and intensive care unit (ICU) settings. Bacterial identification was performed using the Vitek 2 system, and antimicrobial susceptibility testing followed Clinical and Laboratory Standards Institute guidelines. Results: Of the 410 clinically significant isolates, Escherichia coli was the most prevalent, particularly in OPD samples. High methicillin resistance in Staphylococcus aureus and vancomycin resistance in enterococci were noted, especially in ICU settings. ICU isolates, especially Klebsiella , showed marked carbapenem resistance. Multi-drug resistance (MDR) was most common in ICU (58%), with extensively drug-resistant at 22%. The empirical therapy model indicated lower predicted success in ICU compared to OPD and IPD. Conclusion: The high prevalence of MDR, particularly in ICU settings, underscores the need for strict antimicrobial stewardship and infection control. Tailored empirical therapy based on local resistance patterns is essential to improve patient outcomes.