Machine Learning-Based Prediction of Antimicrobial Susceptibility: A Step Towards Precision Antimicrobial Stewardship.

Antimicrobial resistance (AMR) represents an urgent global health crisis exacerbated by the frequent empirical use of broad-spectrum antibiotics. AMR is exacerbated by inherent delays in obtaining culture results and antimicrobial susceptibility data after sample collection. In this study, we developed and validated Machine Learning (ML) models using routinely collected EHR data from inpatient and outpatient encounters to predict antibiotic resistance at the time of blood, urine or respiratory bacterial culture collection. The models demonstrated robust predictive accuracy, particularly in inpatient settings where clinical data was more consistently available. Notably, the model independently identified patterns that predict resistance, similar to how a clinician would attempt to predict resistance using prior culture and susceptibility data combined with their clinical training and knowledge of microbiological resistance patterns. Integrating these predictive tools into clinical workflows could significantly enhance empirical antibiotic selection, reduce unnecessary broad-spectrum antibiotic use, and meaningfully advance antimicrobial stewardship efforts.