Antibiotic de-escalation: finally, some action and not only words

In The Lancet Infectious Diseases, Luis Eduardo Lopéz Cortés and colleagues reported the results of the SIMPLIFY study, a multicentre, non-inferiority, open-label, randomised controlled trial investigating de-escalation of anti-pseudomonal β-lactams in patients with bloodstream infections caused by Enterobacterales.1 De-escalation is an antimicrobial stewardship strategy aimed at reducing the emergence of multidrug-resistant bacteria, collateral damage from the empirical use of broad-spectrum antibiotics.