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. 2017 Aug 15;17(1):565.
doi: 10.1186/s12879-017-2673-5.

Monitoring, documenting and reporting the quality of antibiotic use in the Netherlands: a pilot study to establish a national antimicrobial stewardship registry

Marvin Ah Berrevoets  1   2 , Jaap Ten Oever  3   4 , Tom Sprong  5 , Reinier M van Hest  6 , Ingeborg Groothuis  7 , Inger van Heijl  8 , Jeroen A Schouten  9 , Marlies E Hulscher  9   4 , Bart-Jan Kullberg  3   4
Affiliations

Monitoring, documenting and reporting the quality of antibiotic use in the Netherlands: a pilot study to establish a national antimicrobial stewardship registry

Marvin Ah Berrevoets et al. BMC Infect Dis. .

Abstract

Background: The Dutch Working Party on Antibiotic Policy is developing a national antimicrobial stewardship registry. This registry will report both the quality of antibiotic use in hospitals in the Netherlands and the stewardship activities employed. It is currently unclear which aspects of the quality of antibiotic use are monitored by antimicrobial stewardship teams (A-teams) and can be used as indicators for the stewardship registry. In this pilot study we aimed to determine which stewardship objectives are eligible for the envisioned registry.

Methods: We performed an observational pilot study among five Dutch hospitals. We assessed which of the 14 validated stewardship objectives (11 process of care recommendations and 3 structure of care recommendations) the A-teams monitored and documented in individual patients. They provided, where possible, data to compute quality indicator (QI) performance scores in line with recently developed QIs to measure appropriate antibiotic use in hospitalized adults for the period of January 2015 through December 2015 RESULTS: All hospitals had a local antibiotic guideline describing recommended antimicrobial use. All A-teams monitored the performance of bedside consultations in Staphylococcus aureus bacteremia and the prescription of restricted antimicrobials. Documentation and reporting were the best for the use of restricted antimicrobials: 80% of the A-teams could report data. Lack of time and the absence of an electronic medical record system enabling documentation during the daily work flow were the main barriers hindering documentation and reporting.

Conclusions: Five out of 11 stewardship objectives were actively monitored by A-teams. Without extra effort, 4 A-teams could report on the quality of use of restricted antibiotics. Therefore, this aspect of antibiotic use should be the starting point of the national antimicrobial stewardship registry. Our registry is expected to become a powerful tool to evaluate progress and impact of antimicrobial stewardship programs in hospitals.

Keywords: Antibiotic stewardship; Antimicrobial stewardship program; Antimicrobial stewardship team; Benchmarking; Quality indicator; Quality of care.

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Conflict of interest statement

Authors information

See Title page.

Ethics approval and consent to participate

For this study, no approval of a medical ethics committee was required, since it was part of quality control of drug utilization, observational in nature, data used for this study were already available in the electronic patient records, and data were provided and processed anonymously.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Appropriateness of antibiotic prescriptions. Number in the bars represents the numbers of prescriptions reviewed per category. In hospital “D” pre-authorisation for the use of glycopeptides resulted in an appropriateness of 100%
See this image and copyright information in PMC

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