Empiric options

Empiric therapy is a local question, so answer it with local data

Every empiric decision is a bet placed before the culture is back. The only honest way to improve the odds is to know what the local organisms have been doing.

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Short answer

Empiric therapy is the antibiotic started before culture and susceptibility results are available. Choosing it well means knowing which agents cover the largest share of the organisms actually seen in that specimen source and that unit, which is a local measurement rather than a textbook fact.

Computed from your own isolates, never from a national average.

Coverage, not the highest percentage on the page

A common mistake in reading an antibiogram is to pick the drug with the highest %S. Vancomycin will often show 95 percent or better, but it is only tested against gram positive isolates, so on a mixed bloodstream population it covers a minority of what you might actually be treating.

The empiric ranking under the builder on the homepage is therefore computed as coverage: the share of every isolate in the current selection that was susceptible to that agent. A narrow agent cannot rank first on a broad population, which is the behaviour you want from an empiric list.

The three filters that change the answer

Source, unit and period are not report formatting. They change which organisms are in the denominator, and therefore which agent covers the most of them.

Source decides the organism mix. Urine is dominated by Escherichia coli; respiratory brings Pseudomonas aeruginosa and Staphylococcus aureus.
Unit decides the exposure history. Intensive care isolates have usually met more antibiotics than outpatient isolates.
Period decides how current the answer is, and whether cells survive the reporting threshold.

What this does not do

It does not choose therapy for a patient. It does not know the patient's allergies, renal function, prior culture history, severity of illness or source control status, and it does not know your institutional guideline. It ranks agents by local coverage so that the people who write the guideline have the local number in front of them.

De-escalation, dosing and duration are clinical decisions that sit outside a surveillance tool, and any product that claims otherwise is overselling.

On this site

Every plan and limit is published, with no demo call.

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The builder runs on a synthetic sample dataset, or on your own CSV, parsed in your browser.

Questions

On this page's topic

Can I get empiric rankings by syndrome rather than by source?

Source and unit are the filters in the demo. Syndrome grouping, for example bacteraemia, urinary tract infection and hospital-acquired pneumonia, is part of the Stewardship plan and is built by mapping sources and organisms to the syndrome definitions your team already uses.

Does coverage account for combination therapy?

The ranking is per agent. Combination coverage is a different calculation and a different clinical conversation, and we would rather show one honest number than model a decision we cannot see.

How often should the empiric guideline be revisited?

That is a decision for your program. What changes with a tool like this is the cost of looking, which stops being a reason to wait for the annual cycle.

See your own resistance picture, cut the way you actually work

Build the antibiogram on the synthetic sample dataset, or drop in your own CSV and watch it parse without leaving your browser. When you want an account, one email address is the whole sign-up.

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