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This study aimed to develop a predictive score to identify newly hospitalized patients with high likelihood of receiving antibiotics, thus improving patient inclusion in future studies focusing on antimicrobial stewardship (AMS) programs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This retrospective analysis used data from the PILGRIM study (NCT03765528), which included 1,600 patients across ten international sites. Predictive variables for antibiotic treatment during hospitalization were computed, and an additive score model was developed using logistic regression and 10-fold cross-validation. The PILGRIM score was validated in an independent cohort (validation cohort), with performance metrics assessed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Data from 1,258 patients was included. In the development cohort 52.8% (n =\u00a0445) and in the validation cohort 42.4% (n =\u00a0134) of patients received antibiotics. Key predictors included hematologic malignancies, immunosuppressive medication, and past hospitalization. The logistic regression model demonstrated an area under the curve of 0.74 in the validation. The final additive score incorporated these predictors plus \u201cplanned elective surgery\u201d achieving a specificity of 92%, a positive predictive value of 78%, a sensitivity of 41%, and a negative predictive value (NPV) of 69%in validation set.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The PILGRIM score effectively identifies newly hospitalized patients likely to receive antibiotics, demonstrating high specificity and PPV. Its application can improve future AMS programs and trial recruitment by facilitating targeted inclusion of patients, especially in the hematological and oncological setting. 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MJGTV received consulting fees from Ferring, Tillotts, Bioaster and payment or honoraria for lectures(presentations, speakers bureaus, manuscript writing or educational events from Akademie f\u00fcr \u00c4rztliche Fort- und Weiterbildung, Akadmie f\u00fcr Infektionsmedizin, Astra Zeneca, bioMerieux, DGI, EUMEDICA, European Society of Neurogastroenterology, Falk Foundation, Ferring, FomF GmbH, F\u00f6rderkreis Malteser, Frankfurter B\u00fcrger Universit\u00e4t, GILEAD, GSK, Helios Kliniken, Hessisches Landessozialgericht, Janssen Cilag GmbH, J\u00f6rg Eikerle Beratung, Klinikum Leverkusen, Lahn-Dill Kliniken, Landes\u00e4rztekammer Hessen, LMU Kliniken, Med. Gesellschaft Bad Homburg, MSD, Pfizer, St. Vincent Hospital, Tillotts. All other authors do not have any conflicts of interest with relevance to this work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The PILGRIM study was approved by the ethics committees of all participating sites (ID of lead committee in Cologne: UKK 18 -\u2009316) and written informed consent of all participants was obtained prior to any study related measure. The study was conducted in accordance with the Declaration of Helsinki. The study is registered under ClinicalTrials.gov (ID: NCT03765528).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}]}}