Development of an Antimicrobial Stewardship Intervention Using a Model of Actionable Feedback

Table 1

Parameters of antibiotic prescribing studied in audit and feedback intervention used in the neonatal intensive care unit.

Stewardship concepts	Parameters
Inadequate coverage	(1) Empiric treatment of pathogen with ineffective antibiotic.
Appropriate diagnostic strategy	(2) Number of blood cultures obtained prior to initiation of empiric therapy for late-onset sepsis in infants with and without CVC.
Excessive antibiotics	(3) Days of treatment with broad-spectrum agent rather than narrower-spectrum agent based on pathogen susceptibilities.
	(4) Days of treatment with an agent for gram-negative pathogens following identification of a gram-positive pathogen or vice versa.
Antibiotic duration	(5) Duration of antibiotic treatment for culture-negative sepsis.
Antibiotic prophylaxis	(6) >2 antibiotic/day of perioperative antibiotics for cardiac surgery and >1 antibiotic/day for on-cardiac surgery.