Quality indicators for responsible antibiotic use in the inpatient setting: a systematic review followed by an international multidisciplinary consensus procedure - Université de Lorraine Access content directly
Journal Articles Journal of Antimicrobial Chemotherapy Year : 2018

Quality indicators for responsible antibiotic use in the inpatient setting: a systematic review followed by an international multidisciplinary consensus procedure

Ad Antonisse
  • Function : Author
Michael Borg
  • Function : Author
Franky Buyle
  • Function : Author
Harpal Dhillon
  • Function : Author
Richard Drew
  • Function : Author
David Findlay
  • Function : Author
Abdul Ghafur
  • Function : Author
Lindsay Grayson
  • Function : Author
Elizabeth Hermsen
  • Function : Author
Lauri Hicks
  • Function : Author
Philip Howard
  • Function : Author
Mike Kenston
  • Function : Author
Aaron Kesselheim
  • Function : Author
Charles Knirsch
  • Function : Author
Patrick Lacor
  • Function : Author
Garyfallia Poulakou
  • Function : Author
John Rex
  • Function : Author
Arjun Srinivasan
  • Function : Author
Cecilia Stålsby Lundborg
  • Function : Author
Thomas Tängdén
  • Function : Author
Visanu Thamlikitkul
  • Function : Author
Sally Wellsteed
  • Function : Author
Claudia Wild
  • Function : Author

Abstract

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.

Dates and versions

hal-02361025 , version 1 (13-11-2019)

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Annelie Monnier, Jeroen Schouten, Marion Le Maréchal, Gianpiero Tebano, Céline Pulcini, et al.. Quality indicators for responsible antibiotic use in the inpatient setting: a systematic review followed by an international multidisciplinary consensus procedure. Journal of Antimicrobial Chemotherapy, 2018, 73 (suppl 6), pp.vi30-vi39. ⟨10.1093/jac/dky116⟩. ⟨hal-02361025⟩
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