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. 2018 Jun 1;73(suppl_6):vi59-vi66.
doi: 10.1093/jac/dky119.

Metrics to assess the quantity of antibiotic use in the outpatient setting: a systematic review followed by an international multidisciplinary consensus procedure

Ann Versporten  1 , Inge C Gyssens  2   3 , Céline Pulcini  4   5 , Annelie A Monnier  2   3   6 , Jeroen Schouten  6 , Romina Milanic  7 , Mirjana Stanic Benic  7 , Gianpiero Tebano  4 , Marion Le Maréchal  4 , Veronica Zanichelli  8 , Benedikt Huttner  8   9 , Vera Vlahovic-Palcevski  7 , Herman Goossens  1 , Marlies E Hulscher  6 , Niels Adriaenssens  1   10 ; DRIVE-AB WP1 group
Collaborators, Affiliations

Metrics to assess the quantity of antibiotic use in the outpatient setting: a systematic review followed by an international multidisciplinary consensus procedure

Ann Versporten et al. J Antimicrob Chemother. .

Abstract

Background: The international Innovative Medicines Initiative (IMI) project DRIVE-AB (Driving Reinvestment in Research and Development and Responsible Antibiotic Use) aims to develop a global definition of 'responsible' antibiotic use.

Objectives: To identify consensually validated quantity metrics for antibiotic use in the outpatient setting.

Methods: First, outpatient quantity metrics (OQMs) were identified by a systematic search of literature and web sites published until 12 December 2014. Identified OQMs were evaluated by a multidisciplinary, international stakeholder panel using a RAND-modified Delphi procedure. Two online questionnaires and a face-to-face meeting between them were conducted to assess OQM relevance for measuring the quantity of antibiotic use on a nine-point Likert scale, to add comments or to propose new metrics.

Results: A total of 597 articles were screened, 177 studies met criteria for full-text screening and 138 were finally included. Twenty different OQMs were identified and appraised by 23 stakeholders. During the first survey, 14 OQMs were excluded and 6 qualified for discussion. During the face-to-face meeting, 10 stakeholders retained five OQMs and suggestions were made considering context and combination of metrics. The final set of metrics included defined daily doses, treatments/courses and prescriptions per defined population, treatments/courses and prescriptions per defined number of physician contacts and seasonal variation of total antibiotic use.

Conclusions: A small set of consensually validated metrics to assess the quantity of antibiotic use in the outpatient setting was obtained, enabling (inter)national comparisons. The OQMs will help build a global conceptual framework for responsible antibiotic use.

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Figures

Figure 1.
Figure 1.
Flowchart of included and excluded publications. *Additional search included articles that were included neither in the outpatient concept nor in the inpatient concept search on quantity metrics.
Figure 2.
Figure 2.
Results on OQMs of antibiotic use by RAND-modified Delphi procedure.
See this image and copyright information in PMC

References

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