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Antimicrobial therapy is often initiated in emergency rooms (ERs) and intensive care units (ICUs), where patients are at high risk of infection. Prompt antimicrobial selection is essential in these facilities, and point\u2010of\u2010care testing can guide the appropriate initial antimicrobial therapy. Gram staining, a quick and inexpensive method, was previously used for point\u2010of\u2010care testing by physicians in the 1980s but was discontinued in 1988 in the United States. However, in Japan, the clinical practice of Gram stain\u2010based antimicrobial therapy by physicians has continued in a limited number of hospitals. Several studies undertaken in Japan have shown that Gram staining carried out by trained physicians can reduce the overuse of broad\u2010spectrum antimicrobial agents in ERs and ICUs without worsening patients' outcomes. Gram stain\u2010based antimicrobial therapy reduced unnecessary use of carbapenems in the ER. Furthermore, Gram staining has been shown to significantly reduce the overuse of broad\u2010spectrum antimicrobials without worsening clinical cure and mortality for patients with ventilator\u2010associated pneumonia in the ICU. The classic technique of Gram staining has regained its usefulness through persistent clinical practice in Japan. It is hoped that Japanese researchers in this field will demonstrate to the world the efficacy of the classic technique of Gram staining in addressing this critical problem. Gram staining carried out by trained physicians could serve as a valuable means of optimizing antimicrobial treatment in ERs and ICUs.<\/jats:p>","DOI":"10.1002\/ams2.862","type":"journal-article","created":{"date-parts":[[2023,6,25]],"date-time":"2023-06-25T01:50:43Z","timestamp":1687657843000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Can Gram staining be a guiding tool for optimizing initial antimicrobial agents in bacterial infections?"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4092-8140","authenticated-orcid":false,"given":"Jumpei","family":"Yoshimura","sequence":"first","affiliation":[{"name":"Department of Traumatology and Acute Critical Medicine Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Ogura","sequence":"additional","affiliation":[{"name":"Department of Traumatology and Acute Critical Medicine Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8254-3716","authenticated-orcid":false,"given":"Jun","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Traumatology and Acute Critical Medicine Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,6,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042098614554919"},{"key":"e_1_2_12_3_1","unstructured":"WHO.Antimicrobial resistance: global report on surveillance.2014. 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