ArticleJAC-antimicrobial resistance2026
The guidance ratio: a measure of post-diagnostic antibiotic decision-making.
Article in JAC-antimicrobial resistance, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
Funding
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Abstract
Background: Scalable measures that capture post-diagnostic antibiotic decisions are lacking. We developed and validated the guidance ratio (GR), a registry-based measure of post-diagnostic antibiotic decision-making. Methods: We conducted a retrospective multi-centre validation study of the GR and discontinuation ratio (DR), two registry-based indicators of post-diagnostic antibiotic decision-making in paediatric febrile urinary tract infection. Prescribing outcomes were classified using rule-based algorithms and compared with manually classified outcomes from medical record review. Indicator performance was evaluated against medical record data used as the reference standard. Results: Among 909 episodes, the GR identified guided treatment with a sensitivity of 0.78 and specificity of 1.00. Although registry-based estimates underestimated absolute values, they closely tracked temporal prescribing patterns. Calibration substantially improved agreement with manually classified outcomes. Conclusions: The GR captured clinically meaningful prescribing patterns and may support scalable monitoring of post-diagnostic antibiotic decision-making in stewardship programmes.
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