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Table 2 The standard for evaluation of the appropriateness of antibiotic use

From: Prescriptions patterns and appropriateness of usage of antibiotics in non-teaching community hospitals in South Korea: a multicentre retrospective study

  Optimal Suboptimal Inappropriate
Route of administration A route that is recommended in the Sanford guide   A route that is not recommended in the Sanford guide
Dose Within the range of recommendation of the Sanford guideline the dose was significantly higher than the recommended amount the dose was significantly lower than the recommended amount
Antibiotic class
 Treatment of infectious diseases Antibiotics suggested in the guidelines, antibiotics that are susceptible to identified/possible pathogen Antibiotic spectrum is too broad considering identified/possible pathogen1 Not included in optimal or suboptimal
 Prophylaxis of surgical site infection Adherent to the criteria of ‘The ninth nationwide evaluation of the appropriateness of surgical prophylactic antibiotics in Korean hospitals in 2020’   Not adherent to the criteria of ‘The ninth nationwide evaluation of the appropriateness of surgical prophylactic antibiotics in Korean hospitals in 2020’
 Others The designated infectious disease specialist judged it as ‘appropriate’   The designated infectious disease specialist judged it as ‘inappropriate’
Comprehensive evaluation for antibiotics The route, dose, and class are ‘optimal’ The route is optimal AND dose and/or class is ‘suboptimal’ but not ‘inappropriate’ At least one ‘inappropriate’ exist for the route, dose, or class
Appropriateness of antibiotic prescription by the patient All the prescribed antibiotics were evaluated as ‘optimal’ and there was no unnecessary combination - At least one ‘suboptimal’ antibiotic prescription exists, but there was no ‘inappropriate’ antibiotic prescription
- All the antibiotic prescriptions were ‘optimal’, but the combination was unnecessary
At least one ‘inappropriate’ antibiotic prescription exists
  1. 1Examples of antibiotic spectrum
  2.  < The rank of spectrum for beta-lactams > 
  3. - Rank 1: 3rd generation cephalosporins, Ureido/carboxy-penicillin
  4. - Rank 2: Piperacillin/tazobactam, Ticarcillin/clavulanate, 4th generation cephalosporins, Anti-pseudomonal 3rd generation cephalosporins
  5. - Rank 3: Ertapenem, Imipenem, Meropenem, Doripenem
  6.  < The rank of spectrum for anti-staphylococcal antibiotics > 
  7. - Rank 1: Nafcillin/Oxacillin, 1st generation cephalosporins,
  8. - Rank 2: Vancomycin, Teicoplanin, Linezolid