Feasibility and Utility of Robust Antibiotic Use Risk-Adjustment in Antimicrobial Stewardship Program Assessments (R-SAARs) Study

The CDC’s SAAR (Standardized Antibiotic Administration Ratio), uses a limited number of variables (7) for risk adjusted comparisons to a national benchmark. Adding patient-encounter data, such as diagnosis information, may help make antibiotic use comparisons more meaningful and more efficient in identifying areas for improvement. The goal of this project is to determine whether “Robust” SAARs (R-SAARs) based on risk-adjustment using patient-encounter data are helpful in driving antimicrobial stewardship strategy. 

Fifty US hospitals have successfully participated in this study, from Duke, DASON, and CDC Epicenters collaborative hospitals including University of North Carolina, University of Utah, Intermountain Healthcare, Johns Hopkins University, Rush University, and Stroger Hospital.

Here we provide information for study sites who are actively assessing their Hospital-Specific Data Feedback reports.


Data Feedback Report #1: Unadjusted, Antimicrobial Use (AU) Rate comparisons and 2017 SAARs


Data Feedback Report #2: Patient-encounter characteristics, AU comparisons summarized on the patient-encounter level, and Robust risk-adjusted SAARs (R-SAARs)

  • Methods Document, Part 2
  • Overview Video, Part 2
  • Slides from Overview Video, Part 2


Your hospital’s point-of-contact should receive emails from the study team with the hospital-specific reports and links to survey responses. Study sites should review their hospital’s data, talk among their antimicrobial stewardship team members, and then provide an electronic survey response on behalf of your team, within 4 weeks of receiving each data feedback report.

We highly value your team’s perspective and appreciate your participation in the R-SAARs study!

Thank you!

Please reach out to the Duke University study coordinator, Rachel Addison (Rachel.addison@duke.edu ) or Dr. Rebekah Moehring (Rebekah.moehring@duke.edu) with questions regarding study activities.


This project is supported by a grant from the Centers for Disease Control and Prevention Epicenters Program and is led by the Duke-UNC Prevention Epicenter (IRB Pro000110105, PI: Rebekah Moehring, rebekah.moehring@duke.edu).