PROSPECTIVE COMPARATIVE OUTCOMES OF INFECTIOUS DISEASE VS NON-INFECTIOUS DISEASE CONSULTATION IN ANTIBIOTIC MANAGEMENT: APPROPRIATENESS AND STEWARDSHIP INTERVENTIONS

H. Hemanth, Dr. D. Jothieswari*, K. Nishitha, M. S. Sherlin, V. Vasudha

Background: Antimicrobial resistance (AMR) remains a major global public health concern, largely driven by inappropriate antibiotic prescribing and suboptimal antimicrobial stewardship practices. Infectious Disease (ID) specialists play a crucial role in optimizing antibiotic therapy through evidence-based prescribing, timely de-escalation, and stewardship interventions. However, data comparing antibiotic management outcomes between ID and non-ID physician consultations remain limited, particularly in resource-constrained healthcare settings. Objective: To compare antibiotic prescribing patterns, stewardship interventions, and clinical outcomes among patients managed with Infectious Disease specialist consultation versus non-Infectious Disease physician consultation. Methods: A prospective observational comparative study was conducted among 210 hospitalized patients receiving antibiotic therapy between November 2024 and March 2025. Patients were categorized into an ID consultation group (n=70) and a non-ID consultation group (n=140). Demographic characteristics, duration of hospitalization, antibiotic exposure, spectrum of antimicrobial therapy, and stewardship interventions were assessed. Statistical analysis was performed using independent t-tests, chi-square tests, and logistic regression. Results: The mean age was comparable between groups (57.26 ± 17.63 vs 59.12 ± 17.21 years; p=0.464). Patients in the ID consultation group demonstrated significantly longer hospital stay (8.79 ± 6.30 vs 6.53 ± 3.45 days; p=0.001) and antibiotic exposure duration (6.34 ± 3.13 vs 5.45 ± 2.29 days; p=0.023). Significant differences were observed in antimicrobial stewardship interventions on Day 3, Day 5, and Day 7 (p<0.001). Logistic regression analysis revealed that ID physician involvement was not independently associated with broad-spectrum antibiotic utilization (OR=1.167, 95% CI: 0.635–2.146, p=0.618). Conclusion: Infectious Disease consultation was associated with significantly greater stewardship intervention activity and enhanced antibiotic optimization practices. These findings support the integration of ID specialists into antimicrobial stewardship programs to improve antibiotic management and promote rational antimicrobial use.