Background: Due to the rising incidence of ESBL-producing bacterial infections, the use of carbapenems has increased over recent decades. Carbapenems are part of the group of last-resort antimicrobials and are used widely as empirical therapy, which is contributing to the growing rate of antimicrobial resistance (AMR). De-escalation has been proven to be a successful tool in antimicrobial stewardship programmes (ASPs) in minimising the occurrence of AMR and decreasing the use of antimicrobials. The purpose of the study was to find the reasons why prescribers do not de-escalate from empiric carbapenem therapy. Methods: This retrospective quantitative study was conducted in a private hospital in South Africa. The infection markers and cultures of these patients were considered. Results: De-escalation was practiced in 17% of the patients. Empiric carbapenem therapy was started in 11.2% of patients and the most prescribed carbapenem was ertapenem (62.4%). Cultures were available in 71.1% of the study population. De-escalation was not performed in 83% of patients, mostly since their infection markers decreased with carbapenem therapy (45.9%) or because of culture unavailability (28.9%). Conclusion: The study came to the conclusion that prescribers do not want to de-escalate once their patients are improving on current treatment or if there are no cultures available.

Simulation-Based Learning (SBL) is an interactive teaching method that replicates real-world clinical settings to train healthcare professionals. Interprofessional Education and Collaborative Practice (IPECP) brings together students from various health disciplines to learn collaboratively, promoting teamwork and effective communication. Although international guidelines support SBL in IPECP and its benefits are well-documented, there is a lack of research on how undergraduate students across different disciplines perceive this approach. This study aimed to assess undergraduate health professions students’ perceptions of SBL as a tool for promoting IPECP across multiple disciplines. A quantitative, retrospective pre-post design was used involving N = 540 undergraduate students from various health disciplines. The Interprofessional Collaborative Competency Attainment Survey (ICCAS) was administered after the SBL intervention. Paired and independent samples t-tests were used to analyze pre- and post-test differences and gender comparisons. Significant improvements (all p < 0.001) were found across all the six interprofessional competency domains. Female students showed significantly higher post-test scores in several domains compared to males, although no pre-test gender differences were observed. SBL significantly enhances students’ perceptions about their interprofessional competencies among first-year undergraduate health students and fosters the development of collaborative practice early in their training. The observed gender differences in post-intervention outcomes highlight the need for further investigation into engagement dynamics within SBL. This study contributes to the limited body of research on undergraduate students' perceptions of SBL in IPECP across multiple disciplines. It offers empirical support for integrating simulation into interprofessional curricula.

Due to the rising incidence of ESBL infections, the use of carbapenems has increased over the past decades. Carbapenems are part of the last resort antimicrobials and are used widely as empirical therapy, which is contributing to the growing rate of antimicrobial resistance (AMR). De-escalation has been proven to be a successful tool of antimicrobial stewardship programmes (ASPs) in minimising the occurrence of AMR and decreasing the use of antimicrobials. The purpose of the study was to find the reasons why prescribers do not de-escalate from empiric carbapenem therapy. This retrospective quantitative study was conducted in a private hospital in South Africa. The infection markers and cultures of these patients were considered. De-escalation was practiced in 17% of the patients. Empiric carbapenem therapy was started in 11.2% of patients and the most prescribed carbapenem was ertapenem (62.4%). Cultures were available in 71.1% of the study population. De-escalation was not performed in 83% of patients, mostly since their infection markers decreased with carbapenem therapy (45.9%) or because of culture unavailability (28.9%). The study came to the conclusion that prescribers do not want to de-escalate once their patients are improving on current treantment or if there are no cultures available.