Antibiotic (AB) resistance is a global health threat, particularly in resource-limited settings like Yemen. Antibiotics misuse, especially in hospitals, is the most important risk for resistance development. Understanding empirical AB use and susceptibility patterns among inpatient settings is crucial for implementing effective antimicrobial stewardship. To evaluate Empirical Antibiotic Therapy (EAT), resistance patterns, and their impact on hospitalized patients’ outcomes. A prospective cross-sectional study was conducted in medical and surgical wards in a tertiary hospital over 2 months, including 80 adult patients for analysis. The patient-level data on antibiotic prescriptions, culture results, patient demographics, clinical characteristics, and treatment outcomes, were collected manually and from computer records. An ethical approval was obtained, and SPSS app was used in analyzing the data. EAT was alarmingly high (98%), often mismatched susceptibility patterns, coupled with high percentage (68.3%) of negative culture results. The most commonly prescribed antibiotics were Ceftriaxone, Vancomycin, Levofloxacin, Meropenem, Imipenem/Cilastatin, and Metronidazole. Significant resistance (>50%) was observed against Moxifloxacin, Clindamycin, and all tested beta-lactam agents except Cefuroxime (42%). Appropriate EAT was associated with good prognosis, P =.029 (Fisher’s Exact Test), and Ceftriaxone use was associated with poorer prognosis, P =.017 ( X 2 Test). The study highlights a notable misuse of EAT coupled with high resistance rate in hospital. These findings underscore the need for effective interventions to optimize antibiotic use and mitigate the growing threat of resistance in Yemen. Strategies such as enhanced diagnostic capabilities, improved stewardship programs, and rational prescribing practices are essential to improve patient outcomes and preserve the effectiveness of antibiotics. • Empirical antibiotic therapy (EAT) was initiated in 98% of hospitalized patients, with a high rate of mismatched susceptibility and 68.3% negative culture results. • Over 50% resistance was observed to most beta-lactam antibiotics, including Ceftriaxone, Cefepime, and Piperacillin/Tazobactam, while only Cefuroxime showed lower resistance (42%). • Appropriate empirical antibiotic use significantly improved patient prognosis (p = .029), whereas Ceftriaxone use was associated with poorer outcomes (p = .017). • Delayed availability of culture results and reliance on empirical therapy contributed to poorer outcomes, with most cultures reported after patient discharge. • The study underscores the urgent need for antimicrobial stewardship, improved diagnostics, and rational prescribing to combat antimicrobial resistance in Yemen's hospital settings.
Alshaikh et al. (Thu,) studied this question.