Clinical Edge

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CDC Metric for Measuring & Comparing Antibiotic Use

Clin Infect Dis; ePub 2018 Feb 2; van Santen, et al

The Standardized Antimicrobial Administration Ratio (SAAR), developed by the Centers for Disease Control & Prevention (CDC), is a new antibiotic use (AU) metric that uses point-of-care, antimicrobial administration data electronically reported to a national surveillance system to enable risk adjusted, AU comparisons across multiple hospitals. SAARs were developed for specific NHSN adult and pediatric patients care locations and cover 5 antimicrobial agent categories: 1) broad-spectrum agents predominantly used for hospital-onset/multi-drug resistant bacteria, 2) broad-spectrum agents predominantly used for community-acquired infections, 3) anti-MRSA agents, 4) agents predominantly used for surgical site infection prophylaxis, and 5) all antibiotic agents. Among the study highlights:

  • Most location-level SAARs were statistically significantly different than 1, in adult locations up to 52% lower than 1, and up to 41% higher than 1.
  • Median SAARs in adults and pediatric ICUs had a range of 0.667-1.119.
  • SAAR distributions serve as an external comparison to national SAARs.

The authors concluded that stewardship programs can use the SAAR metric to identify higher than predicted AU to help drive improvements.


van Santen KL, Edwards JR, Webb AK, et al. The Standardized Antimicrobial Administration Ratio: A new metric for measuring and comparing antibiotic use. [Published online ahead of print February 2, 2018]. Clin Infect Dis. doi:10.1093/cid/ciy075.