ANTIBIOTIC RESISTANCE IN ENT INFECTIONS: A RETROSPECTIVE STUDY OF PRESCRIBING PATTERNS AND MICROBIAL SHIFTS

Abstract

In a retrospective analysis of 1,200 ENT infection episodes treated at a tertiary care center from January 2021 to December 2024, we evaluated antibiotic‐prescribing patterns and corresponding shifts in bacterial susceptibility. Although narrow‐spectrum penicillin use declined from 30% of prescriptions in 2021 to 24% in 2024, broad‐spectrum agents—most notably amoxicillin–clavulanate and macrolides—increased from 16% to 23% and from 12% to 21%, respectively. Streptococcus pneumoniae accounted for 42.9% of isolates, followed by Haemophilus influenzae (28.6%) and Staphylococcus aureus (21.4%). Over the study period, macrolide resistance in S. pneumoniae rose from 12% to 28%, and overall non‐susceptibility to amoxicillin–clavulanate climbed from 10% to 25%. Prolonged antibiotic courses were modestly correlated with resistance emergence, and patients of advancing age showed a higher likelihood of harboring resistant organisms. Multivariable logistic regression revealed that broad‐spectrum antibiotic use was independently associated with increased odds of resistance (OR 1.85; 95% CI 1.42–2.41; p < .001). General practitioners contributed the largest share of broad‐spectrum prescriptions, underscoring the need for targeted outpatient stewardship. These findings demonstrate that even moderate shifts toward broad‐spectrum therapies can accelerate resistance among common ENT pathogens. Integrating rapid diagnostic testing, reinforcing adherence to narrow‐spectrum guidelines for uncomplicated cases, and delivering prescriber‐specific feedback on local resistance trends are critical steps to optimize empirical therapy and preserve antibiotic efficacy in otolaryngology.