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

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

  Number of events
Antibiotics revieweda  
• Carbapenems 37
• 3rd and 4th 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%)
• Othersb (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%)
• Othersb (percentage of similar recommendations) 4 (66.7%)
Potential additional antimicrobial stewardship recommendations based on local guidelines [4] and/or clinical criteria:  
• Discontinuation of antimicrobial therapyc 3
• De-escalation of antibiotic therapyd 5
• Intravenous to enteral switch 3
  1. a16 prescriptions involved 2 different antibiotics.
  2. b”Others” include advice on further investigations (1 case), advice on referral to infectious diseases specialists (2 cases), and discontinuation of concurrent antibiotics (3 cases).
  3. cTreatment of asymptomatic bacteriuria (1 case), continuation of antibiotics after resolution of occult febrile neutropenia (2 cases).
  4. dOral antibiotics for low-risk febrile neutropenia (2 cases), use of narrower-spectrum antibiotics for culture-positive infections (3 cases).