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Table 1 Impact of diagnostic microbiology on antimicrobial prescribing for different prescription episode indications

From: The impact of diagnostic microbiology on de-escalation of antimicrobial therapy in hospitalised adults

Indication typeTotal prescriptions analysedPrescription episodes (PE)PE with micro: all*PE with relevant positive micro *Positive micro result documented **Positive micro with ID/micro team involved **Positive micro where Abx were affected**Positive micro where Abx were de-escalated**PE with only negative micro*Negative micro reviewed & relevantReviewed negative micro result documented***Reviewed negative micro result affected Abx
Respiratory1349056 (62%)10 (11%)7 (70%)7 (70%)5 (50%)1 (10%)45 (50%)194 (21%)0
Urinary514428 (64%)8 (18%)7 (88%)4 (50%)3 (38%)2 (25%)19 (43%)41 (25%)0
Sepsis unclear source513527 (77%)4 (11%)4 (100%)4 (100%)4 (100%)2 (50%)22 (63%)41 (25%)1
Skin and soft tissue443414 (41%)1 (3%)1 (100%)1 (100%)1 (100%)013 (38%)31 (33%)0
Abdominal271811 (61%)2 (11%)2 (100%)2 (100%)2 (100%)08 (44%)31 (33%)0
Other342211 (50%)5 (23%)5 (100%)5 (100%)5 (100%)1 (20%)5 (23%)41 (25%)0
No indication documented413315 (45%)3 (9%)1 (33%)00012 (36%)300
TOTAL382276162 (59%)33 (12%)27 (82%)23 (70%)20 (61%)6 (18%)124 (45%)409 (23%)1 (2.5%)
  1. Table shows the total prescriptions sampled for different indications, the Prescription Episodes analysed (PEs, defined in main text), and various properties of PEs with positive and negative diagnostic microbiology found on detailed notes review. For PEs with positive microbiology, data were collected on whether the microbiology result was documented in the medical records, whether infectious diseases and/or microbiology teams were involved (either by telephone or patient review), whether the antimicrobial regimen was changed as a result of the microbiology and whether that change constituted escalation or de-escalation. For a random sample of PEs with negative microbiology, data were collected on whether the result was acknowledged in the medical records and whether this caused antimicrobial de-escalation. ID Infectious Diseases team. * = Denominator for percentages is all PEs for that indication; ** = Denominator for percentages is all PEs with pathogenic positive microbiology; *** = Denominator for percentages is reviewed PEs with negative microbiology