Quality indicators for responsible antibiotic use in the inpatient setting: A systematic review followed by an international multidisciplinary consensus procedure

Published

Journal Article

© The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. Background: This study was conducted as part of the Driving Reinvestment in Research and Development and Responsible Antibiotic Use (DRIVE-AB) project and aimed to develop generic quality indicators (QIs) for responsible antibiotic use in the inpatient setting. Methods: A RAND-modified Delphimethodwas applied. First, QIswere identified by a systematic review. A complementary search was performed on web sites of relevant organizations. Duplicates were removed and disease and patient-specific QIs were combined into generic indicators. The relevance of these QIs was appraised by a multidisciplinary international stakeholder panel through two questionnaires and an in-between consensus meeting. Results: The systematic review retrieved 70 potential generic QIs. The QIs were appraised by 25 international stakeholders with diverse backgrounds (medical community, public health, patients, antibiotic research and development, regulators, governments). Ultimately, 51 QIs were selected in consensus. QIs with the highest relevance score included: (i) an antibiotic plan should be documented in the medical record at the start of the antibiotic treatment; (ii) the results of bacteriological susceptibility testing should be documented in the medical record; (iii) the local guidelines should correspond to the national guidelines but should be adapted based on local resistance patterns; (iv) an antibiotic stewardship programme should be in place at the healthcare facility; and (v) allergy status should be taken into account when antibiotics are prescribed. Conclusions: This systematic and stepwise method combining evidence from literature and stakeholder opinion led to multidisciplinary international consensus on generic inpatient QIs that can be used globally to assess the quality of antibiotic use.

Full Text

Duke Authors

Cited Authors

  • Monnier, AA; Schouten, J; Le Maréchal, M; Tebano, G; Pulcini, C; Benić, MS; Vlahović-Palĉevski, V; Milanič, R; Adriaenssens, N; Versporten, A; Huttner, B; Zanichelli, V; Hulscher, ME; Gyssens, IC; Antonisse, A; Beović, B; Borg, M; Buyle, F; Cavaleri, M; Dhillon, H; Dumartin, C; Drew, R; Findlay, D; Ghafur, A; Grayson, L; Hermsen, E; Hicks, L; Howard, P; Kenston, M; Kesselheim, AS; Knirsch, C; Lacor, P; Laxminarayan, R; Paul, M; Plachouras, D; Poulakou, G; Rabaud, C; Rex, JH; Rodriguez-Baño, J; Srinivasan, A; Lundborg, CS; Tängdén, T; Thamlikitkul, V; Waluszewski, A; Wellsteed, S; Wertheim, H; Wild, C

Published Date

  • June 1, 2018

Published In

Volume / Issue

  • 73 /

Start / End Page

  • vi30 - vi39

Electronic International Standard Serial Number (EISSN)

  • 1460-2091

International Standard Serial Number (ISSN)

  • 0305-7453

Digital Object Identifier (DOI)

  • 10.1093/jac/dky116

Citation Source

  • Scopus