Quality indicators for responsible antibiotic use in the inpatient setting: a systematic review followed by an international multidisciplinary consensus procedure
Annelie Monnier
(1, 2)
,
Jeroen Schouten
(1)
,
Marion Le Maréchal
(3)
,
Gianpiero Tebano
(3)
,
Céline Pulcini
(3, 4)
,
Mirjana Stanić Benić
(5)
,
Vera Vlahović-Palĉevski
(5)
,
Romina Milanič
(5)
,
Niels Adriaenssens
(6)
,
Ann Versporten
(6)
,
Benedikt Huttner
(7)
,
Veronica Zanichelli
(7)
,
Marlies Hulscher
(1)
,
Inge Gyssens
(1, 2)
,
Ad Antonisse
,
Bojana Beović
(8)
,
Michael Borg
,
Franky Buyle
,
Marco Cavaleri
(9)
,
Harpal Dhillon
,
Catherine Dumartin
(10)
,
Richard Drew
,
David Findlay
,
Abdul Ghafur
,
Lindsay Grayson
,
Elizabeth Hermsen
,
Lauri Hicks
,
Philip Howard
,
Mike Kenston
,
Aaron Kesselheim
,
Charles Knirsch
,
Patrick Lacor
,
Ramanan Laxminarayan
(11)
,
Mical Paul
(12)
,
Diamantis Plachouras
(13)
,
Garyfallia Poulakou
,
Christian Rabaud
(4)
,
John Rex
,
Jesús Rodríguez-Baño
(14)
,
Arjun Srinivasan
,
Cecilia Stålsby Lundborg
,
Thomas Tängdén
,
Visanu Thamlikitkul
,
Alexandra Waluszewski
(15)
,
Sally Wellsteed
,
Heiman Wertheim
(16)
,
Claudia Wild
1
Radboud University Medical Center [Nijmegen]
2 UHasselt - Hasselt University
3 APEMAC - Maladies chroniques, santé perçue, et processus d'adaptation
4 Service des Maladies Infectieuses et Tropicales [CHRU Nancy]
5 University Hospital Rijeka
6 VAXINFECTIO - Vaccine & Infectious Disease Institute [Antwerp, Belgium]
7 Geneva University Hospitals and Geneva University
8 University of Ljubljana
9 EMA - European Medicines Agency [London]
10 BPH - Bordeaux population health
11 CDDEP - Center for Disease Dynamics, Economics & Policy
12 Sackler Faculty of Medicine
13 Fourth Department of Medicine
14 University Hospital Virgen Macarena
15 Uppsala University
16 OUCRU - Oxford University Clinical Research Unit [Ho Chi Minh City]
2 UHasselt - Hasselt University
3 APEMAC - Maladies chroniques, santé perçue, et processus d'adaptation
4 Service des Maladies Infectieuses et Tropicales [CHRU Nancy]
5 University Hospital Rijeka
6 VAXINFECTIO - Vaccine & Infectious Disease Institute [Antwerp, Belgium]
7 Geneva University Hospitals and Geneva University
8 University of Ljubljana
9 EMA - European Medicines Agency [London]
10 BPH - Bordeaux population health
11 CDDEP - Center for Disease Dynamics, Economics & Policy
12 Sackler Faculty of Medicine
13 Fourth Department of Medicine
14 University Hospital Virgen Macarena
15 Uppsala University
16 OUCRU - Oxford University Clinical Research Unit [Ho Chi Minh City]
Jeroen Schouten
- Fonction : Auteur
- PersonId : 780975
- ORCID : 0000-0001-9118-4420
Benedikt Huttner
- Fonction : Auteur
- PersonId : 797155
- ORCID : 0000-0002-1749-9464
Marlies Hulscher
- Fonction : Auteur
- PersonId : 797154
- ORCID : 0000-0002-2160-4810
Ad Antonisse
- Fonction : Auteur
Michael Borg
- Fonction : Auteur
Franky Buyle
- Fonction : Auteur
Harpal Dhillon
- Fonction : Auteur
Richard Drew
- Fonction : Auteur
David Findlay
- Fonction : Auteur
Abdul Ghafur
- Fonction : Auteur
Lindsay Grayson
- Fonction : Auteur
Elizabeth Hermsen
- Fonction : Auteur
Lauri Hicks
- Fonction : Auteur
Philip Howard
- Fonction : Auteur
Mike Kenston
- Fonction : Auteur
Aaron Kesselheim
- Fonction : Auteur
Charles Knirsch
- Fonction : Auteur
Patrick Lacor
- Fonction : Auteur
Garyfallia Poulakou
- Fonction : Auteur
Christian Rabaud
- Fonction : Auteur
- PersonId : 763076
- IdRef : 068555598
John Rex
- Fonction : Auteur
Arjun Srinivasan
- Fonction : Auteur
Cecilia Stålsby Lundborg
- Fonction : Auteur
Thomas Tängdén
- Fonction : Auteur
Visanu Thamlikitkul
- Fonction : Auteur
Sally Wellsteed
- Fonction : Auteur
Claudia Wild
- Fonction : Auteur
Résumé
Background: This study was conducted as part of the Driving Reinvestment in Research and Development and Responsible Antibiotic Use (DRIVE-AB) project and aimed to develop generic quality indicators (QIs) for responsible antibiotic use in the inpatient setting.
Methods: A RAND-modified Delphi method was applied. First, QIs were identified by a systematic review. A complementary search was performed on web sites of relevant organizations. Duplicates were removed and disease and patient-specific QIs were combined into generic indicators. The relevance of these QIs was appraised by a multidisciplinary international stakeholder panel through two questionnaires and an in-between consensus meeting.
Results: The systematic review retrieved 70 potential generic QIs. The QIs were appraised by 25 international stakeholders with diverse backgrounds (medical community, public health, patients, antibiotic research and development, regulators, governments). Ultimately, 51 QIs were selected in consensus. QIs with the highest relevance score included: (i) an antibiotic plan should be documented in the medical record at the start of the antibiotic treatment; (ii) the results of bacteriological susceptibility testing should be documented in the medical record; (iii) the local guidelines should correspond to the national guidelines but should be adapted based on local resistance patterns; (iv) an antibiotic stewardship programme should be in place at the healthcare facility; and (v) allergy status should be taken into account when antibiotics are prescribed.
Conclusions: This systematic and stepwise method combining evidence from literature and stakeholder opinion led to multidisciplinary international consensus on generic inpatient QIs that can be used globally to assess the quality of antibiotic use.