Integrating Precision Sepsis Risk Stratification into Systems-based Antimicrobial Stewardship

Abstract Early broad-spectrum antimicrobial administration in sepsis is strongly associated with improved survival. However, widespread implementation of time-based antibiotic mandates has substantially increased antimicrobial utilization, contributing to escalating global antimicrobial resistance. This creates a fundamental tension in sepsis care: aggressive empiric therapy optimizes short-term outcomes for individual patients but threatens long-term antimicrobial effectiveness at a population