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Table 1 Results of the ASP audit on recommendations and outcomes over 3 years (August 2009 to July 2012)

From: Specialist trainees on rotation cannot replace dedicated consultant clinicians for antimicrobial stewardship of specialty disciplines

  Year 1 Year 2 Year 3
(August 2009 to July 2010) (August 2010 to July 2011) (August 2011 to July 2012)
Number of prescriptions reviewed 1,414 1,168 1,567
Number of antimicrobial stewardship recommendations made (percentage of prescriptions reviewed) 649 (45.9%) 363 (31.1%)b 557 (35.5%)
• Discontinuation of antibiotic therapy 239 135 227
• De-escalation of antibiotic therapy 198 74 176
• Intravenous to enteral switch 49 10 47
• Escalation of antibiotic therapy 25 7 13
• Antibiotic dosing 39 68 49
• Othersa 99 69 45
Recommendation acceptance (percentage of recommendations accepted) 570 (87.7%) 266 (73.3%)b 464 (83.3%)
Antimicrobial prescription (defined daily dose/1,000 inpatient-days)    
• All intravenous antibiotics 468.6 580.3c 513.7
• All carbapenems 130.8 181.2c 149.1
• 3rd and 4th-generation cephalosporins 128.2 95.1d 108.7
• Piperacillin/tazobactam 62.2 116.0c 160.8
• Vancomycin 80.9 108.7e 38.1
  1. a”Others” include advice on duration of antibiotics, further investigations, and advice on referral to infectious diseases specialists.
  2. bStatistically significant difference between Years 1 and 2, and Years 2 and 3, based on the chi-square test.
  3. cStatistically significant difference between Years 1 and 2, and Years 2 and 3, based on Wilcoxon rank-sum test.
  4. dStatistically significant difference between Years 1 and 2 only, based on the Wilcoxon rank-sum test.
  5. eStatistically significant difference between Years 2 and 3 only, based on the Wilcoxon rank-sum test.