Table 1.

Selected Standardized Antimicrobial Administration Ratio (SAAR) Antimicrobial Groupings and Potential Issues

SAAR Antimicrobial Agent Category	Included Antimicrobials (Grouped by Category)			Potential Issues
Adult Broad-spectrum antibacterial agents predominantly used for hospital-onset infections	Cefepime Ceftazidime Piperacillin/tazobactam	Aztreonam (IV only) Amikacin (IV only) Gentamicin (IV only) Tobramycin (IV only)	Doripenem Imipenem/cilastatin Meropenem	• Carbapenems, aztreonam, and potentially aminoglycosides often restricted more than third- and fourth-generation cephalosporins or piperacillin-tazobactam. • Important de-escalation stewardship work occurs within this category that is invisible with this grouping.
Adult Broad-spectrum antibacterial agents predominantly used for community-acquired infections	Cefaclor Cefdinir Cefixime Cefotaxime Cefpodoxime Cefprozil Ceftriaxone Cefuroxime	Ciprofloxacin Gemifloxacin Levofloxacin Moxifloxacin	Ertapenem	• The differences in spectrum and adverse effect profile of included agents lead to important stewardship work within this category (see text).
Adult Antibacterial agents predominantly used for resistant gram-positive infections	Vancomycin (IV only)	Dalbavancin Oritavancin Ceftaroline Telavancin	Daptomycin Linezolid Tedizolid Quinupristin/Dalfopristin	• Dalbavancin and oritavancin would allow hospitals to minimize this SAAR substantially. • Limited use of VRE active agents over vancomycin would not be visible. • De-escalation to vancomycin from other agents in this category would not be trackable.
Adult Antifungal agents predominantly used for invasive candidiasis	Fluconazole	Anidulafungin Caspofungin Micafungin		• De-escalation from micafungin or similar to fluconazole would not be visible.

Note. SAAR, standardized antimicrobial administration ratio; IV, intravenous; VRE, vancomycin-resistant enterococci.