Metrics for quantifying antibiotic use in the hospital setting: results from a systematic review and international multidisciplinary consensus procedure
Mirjana Stanić Benić
(1)
,
Romina Milanič
(1)
,
Annelie Monnier
(2, 3)
,
Inge Gyssens
(2, 3)
,
Niels Adriaenssens
(4)
,
Ann Versporten
(4)
,
Veronica Zanichelli
(5)
,
Marion Le Maréchal
(6)
,
Benedikt Huttner
(5)
,
Gianpiero Tebano
(6)
,
Marlies Hulscher
(2)
,
Céline Pulcini
(6, 7)
,
Jeroen Schouten
(2)
,
Vera Vlahović-Palčevski
(1)
,
Ad Antonisse
,
Bojana Beović
,
Michael Borg
,
Franky Buyle
,
Marco Cavaleri
,
Harpal Dhillon
,
Catherine Dumartin
,
Richard Drew
,
David Findlay
,
Abdul Ghafur
,
Lindsay Grayson
,
Elizabeth Hermsen
,
Lauri Hicks
,
Philip Howard
,
Mike Kenston
,
Aaron Kesselheim
,
Charles Knirsch
,
Patrick Lacor
,
Ramanan Laxminarayan
,
Mical Paul
,
Diamantis Plachouras
,
Garyfallia Poulakou
,
Christian Rabaud
,
John Rex
,
Jesús Rodríguez-Baño
,
Arjun Srinivasan
,
Cecilia Stålsby Lundborg
,
Thomas Tängdén
,
Visanu Thamlikitkul
,
Alexandra Waluszewski
,
Sally Wellsteed
,
Heiman Wertheim
,
Claudia Wild
1
University of Rijeka
2 RadboudUMC - Radboud University Medical Center [Nijmegen]
3 UHasselt - Hasselt University
4 UA - University of Antwerp
5 Geneva University Hospitals and Geneva University
6 APEMAC - Maladies chroniques, santé perçue, et processus d'adaptation
7 Service des Maladies Infectieuses et Tropicales [CHRU Nancy]
2 RadboudUMC - Radboud University Medical Center [Nijmegen]
3 UHasselt - Hasselt University
4 UA - University of Antwerp
5 Geneva University Hospitals and Geneva University
6 APEMAC - Maladies chroniques, santé perçue, et processus d'adaptation
7 Service des Maladies Infectieuses et Tropicales [CHRU Nancy]
Benedikt Huttner
- Function : Author
- PersonId : 797155
- ORCID : 0000-0002-1749-9464
Marlies Hulscher
- Function : Author
- PersonId : 797154
- ORCID : 0000-0002-2160-4810
Jeroen Schouten
- Function : Author
- PersonId : 780975
- ORCID : 0000-0001-9118-4420
Ad Antonisse
- Function : Contributor
Bojana Beović
- Function : Contributor
Michael Borg
- Function : Contributor
Franky Buyle
- Function : Contributor
Marco Cavaleri
- Function : Contributor
Harpal Dhillon
- Function : Contributor
Catherine Dumartin
- Function : Contributor
Richard Drew
- Function : Contributor
David Findlay
- Function : Contributor
Abdul Ghafur
- Function : Contributor
Lindsay Grayson
- Function : Contributor
Elizabeth Hermsen
- Function : Contributor
Lauri Hicks
- Function : Contributor
Philip Howard
- Function : Contributor
Mike Kenston
- Function : Contributor
Aaron Kesselheim
- Function : Contributor
Charles Knirsch
- Function : Contributor
Patrick Lacor
- Function : Contributor
Ramanan Laxminarayan
- Function : Contributor
Mical Paul
- Function : Contributor
Diamantis Plachouras
- Function : Contributor
Garyfallia Poulakou
- Function : Contributor
Christian Rabaud
- Function : Contributor
- PersonId : 763076
- IdRef : 068555598
John Rex
- Function : Contributor
Jesús Rodríguez-Baño
- Function : Contributor
Arjun Srinivasan
- Function : Contributor
Cecilia Stålsby Lundborg
- Function : Contributor
Thomas Tängdén
- Function : Contributor
Visanu Thamlikitkul
- Function : Contributor
Alexandra Waluszewski
- Function : Contributor
Sally Wellsteed
- Function : Contributor
Heiman Wertheim
- Function : Contributor
Claudia Wild
- Function : Contributor
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.