Table 2 Results of a random retrospective audit of 100 ASP-reviewed prescriptions in Year 2

Antibiotics reviewed^a

• Carbapenems

37

• 3^rd and 4^th generation cephalosporins

17

• Piperacillin/tazobactam

32

• Vancomycin

16

• Others

14

Number of antimicrobial stewardship recommendations made:

28

• Discontinuation of antibiotic therapy (percentage of all recommendations)

12 (42.9%)

• De-escalation of antibiotic therapy (percentage of all recommendations)

5 (17.9%)

• Intravenous to enteral switch (percentage of all recommendations)

1 (3.6%)

• Escalation of antibiotic therapy (percentage of all recommendations)

1 (3.6%)

• Antibiotic dosing (percentage of all recommendations)

3 (10.7%)

• Others^b (percentage of all recommendations)

6 (21.4%)

Recommendation acceptance (percentage of all recommendations):

20 (71.4%)

• Discontinuation of antibiotic therapy (percentage of similar recommendations)

9 (75.0%)

• De-escalation of antibiotic therapy (percentage of similar recommendations)

3 (60.0%)

• Intravenous to enteral switch (percentage of similar recommendations)

0 (0%)

• Escalation of antibiotic therapy (percentage of similar recommendations)

1 (100%)

• Antibiotic dosing (percentage of similar recommendations)

3 (100%)

• Others^b (percentage of similar recommendations)

4 (66.7%)

Potential additional antimicrobial stewardship recommendations based on local guidelines [4] and/or clinical criteria:

• Discontinuation of antimicrobial therapy^c

3

• De-escalation of antibiotic therapy^d

5

• Intravenous to enteral switch

3