Letter to the Editor: From antibiotic exposure to antibiotic intensity: Rethinking inpatient stewardship in inflammatory bowel disease

doi:10.3748/wjg.118868

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Sep 7, 2026; 32(33): 118868
Published online Sep 7, 2026. doi: 10.3748/wjg.118868

Letter to the Editor: From antibiotic exposure to antibiotic intensity: Rethinking inpatient stewardship in inflammatory bowel disease

Marco Fiore

Marco Fiore, Department of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy

Author contributions: Fiore M conceived the study, drafted the manuscript, and approved the final version of the manuscript.

Conflict-of-interest statement: The author declares no conflict of interest in publishing the manuscript.

Corresponding author: Marco Fiore, MD, Lecturer, Professor, Department of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Piazza Miraglia 2, Naples 80138, Italy. marco.fiore@unicampania.it

Received: January 13, 2026
Revised: February 11, 2026
Accepted: March 3, 2026
Published online: September 7, 2026
Processing time: 208 Days and 21.8 Hours

Core Tip

Core Tip: Although fewer hospitalized patients with inflammatory bowel disease now receive antibiotics, those treated are exposed to increasingly intensive regimens, with a growing use of broad-spectrum and last-resort agents. This disconnect between exposure prevalence and antibiotic consumption intensity challenges traditional stewardship metrics. An inflammatory bowel disease-tailored inpatient stewardship framework focused on antibiotic intensity, escalation patterns, and indication-specific use, with measurable process and outcome indicators, is urgently needed to preserve antimicrobial effectiveness while safeguarding patient outcomes.