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. 2018 Jun 1;73(suppl_6):vi50-vi58.
doi: 10.1093/jac/dky118.

Metrics for quantifying antibiotic use in the hospital setting: results from a systematic review and international multidisciplinary consensus procedure

Mirjana Stanic Benic  1   2 , Romina Milanic  2 , Annelie A Monnier  3   4   5 , Inge C Gyssens  3   5 , Niels Adriaenssens  6   7 , Ann Versporten  6 , Veronica Zanichelli  8 , Marion Le Maréchal  9 , Benedikt Huttner  8   10 , Gianpiero Tebano  9 , Marlies E Hulscher  4 , Céline Pulcini  9   11 , Jeroen Schouten  4 , Vera Vlahovic-Palcevski  1   2 ; DRIVE-AB WP1 group
Collaborators, Affiliations

Metrics for quantifying antibiotic use in the hospital setting: results from a systematic review and international multidisciplinary consensus procedure

Mirjana Stanic Benic et al. J Antimicrob Chemother. .

Abstract

Background: Quantifying antibiotic use is an essential element of antibiotic stewardship since it allows comparison between different settings and time windows, and measurement of the impact of interventions. However, quantity metrics (QMs) and methods have not been standardized.

Objectives: To propose a set of QMs for antibiotic use in inpatients (IQMs) that are accepted globally by professionals in a range of disciplines. The study was conducted within the Driving Reinvestment in Research and Development and Responsible Antibiotic Use (DRIVE-AB) project.

Methods: A systematic literature review using MEDLINE identified articles on measuring inpatient antibiotic use, published up to 29 January 2015. A consensually selected list of national and international web sites was screened for additional IQMs. IQMs were classified according to the type of numerator used and presented to a multidisciplinary panel of stakeholders. A RAND-modified Delphi consensus procedure, which consisted of two online questionnaires and a face-to-face meeting, was performed.

Results: The systematic literature review and web site search identified 168 eligible articles from which an initial list of 20 IQMs, composed of 20 different numerators and associated denominators was developed. The consensus procedure resulted in a final set of 12 IQMs. Among this final set, DDDs per 100(0) patient-days and days of therapy per patient-days were most frequently found in the review. The panel recommended that antibiotic use should be expressed in at least two metrics simultaneously.

Conclusions: Our consensus procedure identified a set of IQMs that we propose as an evidence-based global standard.

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Figures

Figure 1.
Figure 1.
The flow chart of the systematic review process of the literature.
Figure 2.
Figure 2.
Results of the four-step RAND-modified Delphi procedure.
See this image and copyright information in PMC

References

    1. Aminov RI. A brief history of the antibiotic era: lessons learned and challenges for the future. Front Microbiol 2010; 1: 134.. - PMC - PubMed
    1. Thabit AK, Crandon JL, Nicolau DP.. Antimicrobial resistance: impact on clinical and economic outcomes and the need for new antimicrobials. Expert Opin Pharmacother 2015; 16: 159–77. - PubMed
    1. Monnier AA, Eisenstein BI, Hulscher ME. et al. What is responsible antibiotic use? Towards a global definition. In: ESCMID Publications: 27th European Congress of Clinical Microbiology and Infectious Diseases, Vienna, Austria, 2017. Poster P1063. European Society of Clinical Microbiology and Infectious Diseases, Basel, Switzerland.
    1. Centers for Disease Control and Prevention (CDC). Core Elements of Hospital Antibiotic Stewardship Programs 2016. http://www.cdc.gov/getsmart/healthcare/implementation/core-elements.html. - PMC - PubMed
    1. Zanichelli V, Monnier AA, Gyssens IC. et al. Variation in antibiotic use among and within different settings: a systematic review. J Antimicrob Chemother 2018; 73Suppl 6: vi17–vi29. - PMC - PubMed

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