Assessment of Quality Indicators for Appropriate Antibiotic Use
Copyright © 2018 American Society for Microbiology..
One of the critical elements of antimicrobial stewardship programs is the ability to measure the quality of antibiotic prescriptions. The aims of the present study were to evaluate the performance properties of a set of previously developed quality indicators (QIs) and to identify the potential room for improvement in antibiotic use in our setting. A monthly cross-sectional point prevalence survey was conducted in a 400-bed acute care teaching hospital, from June to November 2015. All adult patients treated for ≥24 hours with antibiotic therapy for a suspected hospital- or community-acquired bacterial infection were included. Performance scores (adherence, room for improvement, interobserver reliability, and applicability) were calculated for 8 QIs. A total of 362 patients were evaluated. Adherence to the whole set of QIs was accomplished for 14.1% of evaluable patients. The QIs with greater room for improvement were adequate request for blood cultures (60.6%), therapeutic drug monitoring (TDM) (59.1%), sequential antibiotic therapy within 72 hours (48.2%), and empirical antibiotic therapy according to local guidelines (30.4%). The percentage of patients receiving unnecessary antibiotic treatment in the absence of clinical or microbiological evidence of infection after 5 days was 12.2%. All indicators scored kappa values of ≥0.6, suggesting good interobserver reliability. Low applicability (6.1% of reviewed patients) was found only for the TDM QI. The QIs analyzed were found to be applicable, showed good interobserver reliability, and were useful tools to identify areas with potential room for improvement in antibiotic use.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2018 |
|---|---|
| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:62 |
|---|---|
| Enthalten in: |
Antimicrobial agents and chemotherapy - 62(2018), 12 vom: 25. Dez. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Arcenillas, Paula [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Anti-Bacterial Agents |
|---|
| Anmerkungen: |
Date Completed 23.10.2019 Date Revised 23.10.2019 published: Electronic-Print Citation Status MEDLINE |
|---|
| doi: |
10.1128/AAC.00875-18 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM288860128 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM288860128 | ||
| 003 | DE-627 | ||
| 005 | 20231225061253.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2018 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1128/AAC.00875-18 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n0962.xml |
| 035 | |a (DE-627)NLM288860128 | ||
| 035 | |a (NLM)30249698 | ||
| 035 | |a (PII)e00875-18 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Arcenillas, Paula |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Assessment of Quality Indicators for Appropriate Antibiotic Use |
| 264 | 1 | |c 2018 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 23.10.2019 | ||
| 500 | |a Date Revised 23.10.2019 | ||
| 500 | |a published: Electronic-Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2018 American Society for Microbiology. | ||
| 520 | |a One of the critical elements of antimicrobial stewardship programs is the ability to measure the quality of antibiotic prescriptions. The aims of the present study were to evaluate the performance properties of a set of previously developed quality indicators (QIs) and to identify the potential room for improvement in antibiotic use in our setting. A monthly cross-sectional point prevalence survey was conducted in a 400-bed acute care teaching hospital, from June to November 2015. All adult patients treated for ≥24 hours with antibiotic therapy for a suspected hospital- or community-acquired bacterial infection were included. Performance scores (adherence, room for improvement, interobserver reliability, and applicability) were calculated for 8 QIs. A total of 362 patients were evaluated. Adherence to the whole set of QIs was accomplished for 14.1% of evaluable patients. The QIs with greater room for improvement were adequate request for blood cultures (60.6%), therapeutic drug monitoring (TDM) (59.1%), sequential antibiotic therapy within 72 hours (48.2%), and empirical antibiotic therapy according to local guidelines (30.4%). The percentage of patients receiving unnecessary antibiotic treatment in the absence of clinical or microbiological evidence of infection after 5 days was 12.2%. All indicators scored kappa values of ≥0.6, suggesting good interobserver reliability. Low applicability (6.1% of reviewed patients) was found only for the TDM QI. The QIs analyzed were found to be applicable, showed good interobserver reliability, and were useful tools to identify areas with potential room for improvement in antibiotic use | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a antibiotic stewardship | |
| 650 | 4 | |a antimicrobial resistance | |
| 650 | 4 | |a quality indicators | |
| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 700 | 1 | |a Boix-Palop, Lucía |e verfasserin |4 aut | |
| 700 | 1 | |a Gómez, Lucía |e verfasserin |4 aut | |
| 700 | 1 | |a Xercavins, Mariona |e verfasserin |4 aut | |
| 700 | 1 | |a March, Pablo |e verfasserin |4 aut | |
| 700 | 1 | |a Martinez, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Riera, Montserrat |e verfasserin |4 aut | |
| 700 | 1 | |a Madridejos, Rosa |e verfasserin |4 aut | |
| 700 | 1 | |a Badia, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a Nicolás, Jordi |e verfasserin |4 aut | |
| 700 | 1 | |a Calbo, Esther |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Antimicrobial agents and chemotherapy |d 1972 |g 62(2018), 12 vom: 25. Dez. |w (DE-627)NLM000026506 |x 1098-6596 |7 nnns |
| 773 | 1 | 8 | |g volume:62 |g year:2018 |g number:12 |g day:25 |g month:12 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1128/AAC.00875-18 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 62 |j 2018 |e 12 |b 25 |c 12 | ||