We compared rates of appropriateness and spectrum between LEBA, SCBA and actually prescribed antimicrobial therapy by the treating physician.
Our strategy was based on the rating of appropriateness criteria; as proposed by Gertman and Restuccia [ 27], meeting a single appropriateness criterion sufficed to define care as appropriate.
The rule based rating of appropriateness also assessed a large majority of cases as having made contacts that were both necessary and sufficient.
Statements were classified and agreed to as valid based on the median rating of appropriateness and the degree of panel agreement (dispersion).
Seasonal variations in rates of appropriateness should not be a limitation of this work as it was carried out using a random sample over a one-year period.
The rule based rating of appropriateness also assessed a large majority of cases as having made contacts that were both necessary and sufficient, with more calls assessed as having resulted in unnecessary contacts than insufficient contacts at each survey (Table 3).
Our primary outcome was the rate of override appropriateness, which indicates how many overrides could be regarded as clinically justifiable.
The rate of antibiotic appropriateness was 43% for pulmonary infection (ventilator associated pneumonia and pneumonia), 80% for urinary tract infection, and 100% for the others sites.
