{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:24:26Z","timestamp":1791559466094,"version":"4.3.4"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The Standardized Antimicrobial Administration Ratio (SAAR) is a risk-adjusted metric of antimicrobial use (AU) developed by the Centers for Disease Control and Prevention (CDC) in 2015 as a tool for hospital antimicrobial stewardship programs (ASPs) to track and compare AU with a national benchmark. In 2018, CDC updated the SAAR by expanding the locations and antimicrobial categories for which SAARs can be calculated and by modeling adult and pediatric locations separately.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We identified eligible patient-care locations and defined SAAR antimicrobial categories. Predictive models were developed for eligible adult and pediatric patient-care locations using negative binomial regression applied to nationally aggregated AU data from locations reporting\u2005\u22659 months of 2017 data to the National Healthcare Safety Network (NHSN).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>2017 Baseline SAAR models were developed for 7 adult and 8 pediatric SAAR antimicrobial categories using data reported from 2156 adult and 170 pediatric locations across 457 hospitals. The inclusion of step-down units and general hematology-oncology units in adult 2017 baseline SAAR models and the addition of SAARs for narrow-spectrum B-lactam agents, antifungals predominantly used for invasive candidiasis, antibacterial agents posing the highest risk for Clostridioides difficile infection, and azithromycin (pediatrics only) expand the role SAARs can play in ASP efforts. Final risk-adjusted models are used to calculate predicted antimicrobial days, the denominator of the SAAR, for 40 SAAR types displayed in NHSN.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>SAARs can be used as a metric to prompt investigation into potential overuse or underuse of antimicrobials and to evaluate the effectiveness of ASP interventions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciaa326","type":"journal-article","created":{"date-parts":[[2020,3,25]],"date-time":"2020-03-25T20:10:41Z","timestamp":1585167041000},"page":"e702-e709","source":"Crossref","is-referenced-by-count":40,"title":["National Healthcare Safety Network Standardized Antimicrobial Administration Ratios (SAARs): A Progress Report and Risk Modeling Update Using 2017 Data"],"prefix":"10.1093","volume":"71","author":[{"given":"Erin N","family":"O\u2019Leary","sequence":"first","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"Lantana Consulting Group, Inc, Thetford, Vermont, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan R","family":"Edwards","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melinda M","family":"Neuhauser","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy K","family":"Webb","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"Lantana Consulting Group, Inc, Thetford, Vermont, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minn M","family":"Soe","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauri A","family":"Hicks","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Wise","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"Lantana Consulting Group, Inc, Thetford, Vermont, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsiu","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A","family":"Pollock","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,3,26]]},"reference":[{"key":"2020121703251637000_CIT0001","doi-asserted-by":"crossref","first-page":"1748","DOI":"10.1093\/jac\/dku046","article-title":"Effect of antibiotic stewardship programmes on Clostridium difficile incidence: a systematic review and 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National Quality Forum measure #2720","author":"National Quality Forum"},{"key":"2020121703251637000_CIT0008","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1017\/ice.2017.54","article-title":"A novel metric to monitor the influence of antimicrobial stewardship activities","volume":"38","author":"Livorsi","year":"2017","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2020121703251637000_CIT0009","volume-title":"AU option case examples: targeting a reduction in fluoroquinolone use within a community hospital","author":"Shaw"},{"key":"2020121703251637000_CIT0010","volume-title":"CDC locations and descriptions and instructions for mapping patient care locations","author":"Centers for Disease Control and Prevention"},{"key":"2020121703251637000_CIT0011","volume-title":"Annual AU option data validation","author":"Centers for Disease Control and Prevention"},{"key":"2020121703251637000_CIT0012","doi-asserted-by":"crossref","first-page":"e0120452","DOI":"10.1371\/journal.pone.0120452","article-title":"Declining incidence of candidemia and the shifting epidemiology of Candida resistance in two U.S. metropolitan areas, 2008\u20132013: results from population-based surveillance","volume":"10","author":"Cleveland","year":"2015","journal-title":"PLoS ONE"},{"key":"2020121703251637000_CIT0013","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.15585\/mmwr.mm6544e1","article-title":"Investigation of the first seven reported cases of Candida auris, a globally emerging invasive, multidrug-resistant fungus\u2014United States, May 2013-August 2016","volume":"65","author":"Vallabhaneni","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2020121703251637000_CIT0014","doi-asserted-by":"crossref","first-page":"1677","DOI":"10.1093\/cid\/ciy354","article-title":"Benchmarking inpatient antimicrobial use: a comparison of risk-adjusted observed-to-expected ratios","volume":"67","author":"Yu","year":"2018","journal-title":"Clin Infect Dis"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciaa326\/33707389\/ciaa326.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/71\/10\/e702\/34933095\/ciaa326.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/71\/10\/e702\/34933095\/ciaa326.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T20:13:08Z","timestamp":1608322388000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/71\/10\/e702\/5812159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,26]]},"references-count":14,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2020,3,26]]},"published-print":{"date-parts":[[2020,12,17]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciaa326","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,11,15]]},"published":{"date-parts":[[2020,3,26]]}}}