RESEARCH ARTICLE Development of quality in n

to health care, affecting millions of patients around the world each year [1]. The average cost of care for a records by the treating clinicians, specific sepsis-targeted measures may not have been performed and antimicrobial van den Bosch et al. BMC Infectious Diseases 2014, 14:345 http://www.biomedcentral.com/1471-2334/14/345antimicrobial use in patients with severe sepsis or septicMeibergdreef 9, 1105, AZ, Amsterdam Zuidoost, The Netherlands Full list of author information is available at the end of the articlepatient with severe sepsis is about 22.000 USD [2]. It is often thought that severe sepsis is primarily seen on the intensive care unit (ICU). However, studies point out that the majority (50 – 68%) of patients with severe sepsis are admitted to a general medical ward [3], with a use may have been inappropriate [3]. As the necessary first step in the improvement of appropriate use in patients with sepsis, guidelines have been developed that describe appropriate antimicrobial use in patients with sepsis admitted to a general medical ward or an Intensive Care Unit (ICU). Despite the avail-ability of these guidelines, antimicrobials are used inappro-priately: several studies show that inappropriate initia