eTable 4.

Clinical details of patients who had antibiotic therapy broadened during initial hospitalization

Initial Therapy	Reasons for antibiotic change identified from chart review
Guideline = 10	Ampicillin to ceftriaxone: - 1 patient with clinical worsening - 1 patient with coincident urinary tract infection due to resistant organism - 4 patients without evidence of clinical worsening or documentation of rationale Addition of a macrolide: - 3 patients without evidence of clinical worsening or documentation of rationale Addition of clindamycin: - 1 patient with clinical worsening
Non-guideline = 4	Ceftriaxone to clindamycin: - 1 patient with clinical worsening Addition of a macrolide: - 1 patient with clinical worsening - 1 patients without evidence of clinical worsening or documentation of rationale Addition of clindamycin: - 1 patient with clinical worsening