Updating hospital empiric therapy for ESBL UTI amid rising resistance

[Emma23]

I'm an infectious disease pharmacist at a community hospital, and I'm increasingly concerned about our local patterns of antimicrobial resistance, particularly with ESBL-producing organisms in urinary tract infections. Our current empiric therapy guidelines feel outdated given the rising resistance rates. For other clinicians or pharmacists involved in stewardship, how have you successfully updated institutional protocols to balance effective empiric coverage with the need to conserve broader-spectrum agents? What strategies have been most effective for educating prescribers, especially in outpatient or emergency settings, and how do you leverage local antibiogram data to make a compelling case for change? I'm also interested in any experience with rapid diagnostic tests and how they've impacted your decision-making.