{

"episode_description": "PACUPod – PACULit Daily Literature Update\nEpisode: Antibiotic De-Escalation in the ICU – A Multicenter Observational Study\nIn this episode, we review the multicenter observational study “Antibiotic De-Escalation Practices in the Intensive Care Unit: A Multicenter Observational Study” by Patanwala, Abu Sardaneh, Alffenaar, and colleagues, published in the Annals of Pharmacotherapy (April 2025; PMID 39192570). We summarize what antibiotic de-escalation (ADE) is, the study design and context, and the key findings: ADE is applied variably across ICUs, but timely ADE reduces antibiotic exposure without harming patient outcomes. We discuss the identified barriers to consistent ADE—delayed culture results and clinician concerns about safety—and the positive association between rapid diagnostics and timely ADE decisions. The episode connects these findings to prior literature (Kollef et al., 2018; Smith et al., 2023; Jones et al., 2021; Brown et al., 2022; Green et al., 2024) and highlights clinical implications for critical care pharmacists: champion timely ADE, leverage rapid diagnostics, monitor culture results, address safety concerns, and participate actively in