Quality Indicators to Measure Appropriate Antibiotic Use in Hospitalized Adults

van den Bosch, Caroline M. A.; Geerlings, Suzanne E.; Natsch, Stephanie; Prins, Jan M.; Hulscher, Marlies E. J. L.
January 2015
Clinical Infectious Diseases;Jan2015, Vol. 60 Issue 2, p281
Academic Journal
This article describes the systematic development of a set of generic quality indicators to meet an important requirement for an effective stewardship program: the ability to measure appropriateness of hospital antibiotic use, at the patient level along the entire antibiotic pathway.Background. An important requirement for an effective antibiotic stewardship program is the ability to measure appropriateness of antibiotic use. The aim of this study was to develop quality indicators (QIs) that can be used to measure appropriateness of antibiotic use in the treatment of all bacterial infections in hospitalized adult patients.Methods. A RAND-modified Delphi procedure was used to develop a set of QIs. Potential QIs were retrieved from the literature. In 2 questionnaire mailings with an in-between face-to-face consensus meeting, an international multidisciplinary expert panel of 17 experts appraised and prioritized these potential QIs.Results. The literature search resulted in a list of 24 potential QIs. Nine QIs describing recommended care at patient level were selected: (1) take 2 blood cultures, (2) take cultures from suspected sites of infection, (3) prescribe empirical antibiotic therapy according to local guideline, (4) change empirical to pathogen-directed therapy, (5) adapt antibiotic dosage to renal function, (6) switch from intravenous to oral, (7) document antibiotic plan, (8) perform therapeutic drug monitoring, and (9) discontinue antibiotic therapy if infection is not confirmed. Two QIs describing recommended care at the hospital level were also selected: (1) a local antibiotic guideline should be present, and (2) these local guidelines should correspond to the national antibiotic guidelines.Conclusions. The selected QIs can be used in antibiotic stewardship programs to determine for which aspects of antibiotic use there is room for improvement. At this moment we are testing the clinimetric properties of these QIs in 1800 hospitalized patients, in 22 Dutch hospitals.


Related Articles

  • Does adding routine antibiotics to animal feed pose a serious risk to human health?: YES. Wallinga, David // BMJ: British Medical Journal;7/20/2013, Vol. 347 Issue 7917, p18 

    The article focuses on the impact of adding antibiotics to animal feed on the health of human beings. It mentions that the addition of antibiotics in livestock and poultry production can cause several health problems to human. It states that resistant infections in human beings cause more...

  • Does adding routine antibiotics to animal feed pose a serious risk to human health?: NO. Burch, David G. S. // BMJ: British Medical Journal;7/20/2013, Vol. 347 Issue 7917, p18 

    In this article, the author reports that the addition of antibiotics in animal feed does not posses harm to human health. According to the author, antibiotics enhance the quality of animal feed that helps in increasing livestock and poultry production. He states that antibiotics in feeds help in...

  • Reliability and validity of the Spanish Glasgow Benefit Inventory after cochlear implant surgery in adults. Sanchez-Cuadrado, Isabel; Lassaletta, Luis; Perez-Mora, Rosa; Muñoz, Elena; Gavilan, Javier // European Archives of Oto-Rhino-Laryngology;Feb2015, Vol. 272 Issue 2, p333 

    In recent years, the outcome assessment of subjects undergoing otorhinolaryngological (ORL) intervention has relied increasingly upon patient-reported questionnaires. The English Glasgow Benefit Inventory (GBI) is a reliable, sensitive and validated post-intervention questionnaire that is used...

  • Healthy Canadians in 2010? Millar, John S. // CMAJ: Canadian Medical Association Journal;6/27/2000, Vol. 162 Issue 13, p1823 

    Comments on the need for the development of health information in Canada as of July 2000. Enhancement of health surveillance capabilities of Health Canada and funding of Health Information Roadmap Initiative; Health indicators to support the process; Need for a pan-Canadian process for...

  • USING THE BRADEN AND GLASGOW SCALES TO PREDICT PRESSURE ULCER RISK IN PATIENTS HOSPITALIZED AT INTENSIVE CARE UNITS. Fernandes, Luciana Magnani; Larcher Caliri, Maria Helena // Revista Latino-Americana de Enfermagem (RLAE);nov/dez2008, Vol. 16 Issue 6, p973 

    Pressure ulcers remain a major health issue for critical patients. The purpose of this descriptive and exploratory study was to analyze the risk factors for the development of pressure ulcers in patients hospitalized at an intensive care unit of a university hospital. Patients were assessed...

  • Understanding patient risks.  // Kai Tiaki Nursing New Zealand;Dec2013/Jan2014, Vol. 19 Issue 11, p10 

    No abstract available.

  • The Assessment of Quality of Life (AQoL) instrument: a psychometric measure of health-related quality of life. Hawthorne, Graeme; Richardson, Jeff; Osborne, Richard; Hawthorne, G; Richardson, J; Osborne, R // Quality of Life Research;May1999, Vol. 8 Issue 3, p209 

    This paper describes constructing the Assessment of Quality of Life (AQoL) instrument; designed to measure health-related quality of life (HRQoL), and to be the descriptive system for a multi-attribute utility instrument. Unlike previous utility instruments' descriptive systems, the AQoL's has...

  • Pathophysiological idiosyncrasies and pharmacokinetic realities may interfere with tacrolimus dose titration in liver transplantation. Oteo, Itziar; Lukas, John; Leal, Nerea; Suarez, Elena; Valdivieso, Andres; Gastaca, Mikel; Urbina, Jorge; Calvo, Rosario // European Journal of Clinical Pharmacology;Jul2011, Vol. 67 Issue 7, p671 

    Purpose: To explore the main factors that make it difficult to empirically monitor tacrolimus (TAC) in the early period post-liver transplantation (LTx), with a specific focus on those aspects related to patient idiosyncrasy and clinical status as well as to the pharmacokinetic (PK) assumptions...

  • New-style EMCDDA expert meetings promote integrated approach to monitoring. Vicente, Julián; Simon, Roland // Drugnet Europe;Oct-Dec2013, Issue 84, p2 

    The article discusses two meetings of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), one regarding drug problem management in Europe from September 23-27, 2013, and another on drug-related deaths indicator (DRD) and drug-related infectious diseases indicator (DRID) from...


Read the Article

Courtesy of

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics