Metrics to assess the quantity of antibiotic use in the outpatient setting: a systematic review followed by an international multidisciplinary consensus procedure
Ann Versporten
(1)
,
Inge Gyssens
(2, 3)
,
Céline Pulcini
(4, 5)
,
Annelie Monnier
(2, 3)
,
Jeroen Schouten
(2)
,
Romina Milanič
(6)
,
Mirjana Stanić Benić
(6)
,
Gianpiero Tebano
(4)
,
Marion Le Maréchal
(4)
,
Veronica Zanichelli
(7)
,
Benedikt Huttner
(7)
,
Vera Vlahović-Palčevski
(6)
,
Herman Goossens
(1)
,
Marlies Hulscher
(2)
,
Niels Adriaenssens
(1)
,
Bojana Beović
,
Luis Bavestrello
,
Jon Cohen
,
Pieter-Jan Cortoos
,
Harpal Dhillon
,
Richard Drew
,
Prabhavathi Fernandes
,
David Findlay
,
Ian Friedland
,
Ian Gould
,
Lauri Hicks
,
Christopher Longshaw
,
Carl Llor
,
Allison Mcgeer
,
Iruka Okeke
,
Diamantis Plachouras
,
Garyfallia Poulakou
,
John Rex
,
Thomas Tängdén
,
Laura Trolle Saust
,
Claudine Richon
,
France Roblot
,
Robert Vander Stichele
,
Marcel Verweij
,
Heiman Wertheim
1
UA -
University of Antwerp
2 Radboud University Medical Center [Nijmegen]
3 UHasselt - Hasselt University
4 APEMAC - Maladies chroniques, santé perçue, et processus d'adaptation
5 Service des Maladies Infectieuses et Tropicales [CHRU Nancy]
6 University of Rijeka
7 Geneva University Hospitals and Geneva University
2 Radboud University Medical Center [Nijmegen]
3 UHasselt - Hasselt University
4 APEMAC - Maladies chroniques, santé perçue, et processus d'adaptation
5 Service des Maladies Infectieuses et Tropicales [CHRU Nancy]
6 University of Rijeka
7 Geneva University Hospitals and Geneva University
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
Bojana Beović
- Fonction : Collaborateur
Luis Bavestrello
- Fonction : Collaborateur
Jon Cohen
- Fonction : Collaborateur
Pieter-Jan Cortoos
- Fonction : Collaborateur
Harpal Dhillon
- Fonction : Collaborateur
Richard Drew
- Fonction : Collaborateur
Prabhavathi Fernandes
- Fonction : Collaborateur
David Findlay
- Fonction : Collaborateur
Ian Friedland
- Fonction : Collaborateur
Ian Gould
- Fonction : Collaborateur
Lauri Hicks
- Fonction : Collaborateur
Christopher Longshaw
- Fonction : Collaborateur
Carl Llor
- Fonction : Collaborateur
Allison Mcgeer
- Fonction : Collaborateur
Iruka Okeke
- Fonction : Collaborateur
Diamantis Plachouras
- Fonction : Collaborateur
Garyfallia Poulakou
- Fonction : Collaborateur
John Rex
- Fonction : Collaborateur
Thomas Tängdén
- Fonction : Collaborateur
Laura Trolle Saust
- Fonction : Collaborateur
Claudine Richon
- Fonction : Collaborateur
France Roblot
- Fonction : Collaborateur
Robert Vander Stichele
- Fonction : Collaborateur
Marcel Verweij
- Fonction : Collaborateur
Heiman Wertheim
- Fonction : Collaborateur
Résumé
Background:
The international Innovative Medicines Initiative (IMI) project DRIVE-AB (Driving Reinvestment in Research and Development and Responsible Antibiotic Use) aims to develop a global definition of 'responsible' antibiotic use.
Objectives:
To identify consensually validated quantity metrics for antibiotic use in the outpatient setting.
Methods:
First, outpatient quantity metrics (OQMs) were identified by a systematic search of literature and web sites published until 12 December 2014. Identified OQMs were evaluated by a multidisciplinary, international stakeholder panel using a RAND-modified Delphi procedure. Two online questionnaires and a face-to-face meeting between them were conducted to assess OQM relevance for measuring the quantity of antibiotic use on a nine-point Likert scale, to add comments or to propose new metrics.
Results:
A total of 597 articles were screened, 177 studies met criteria for full-text screening and 138 were finally included. Twenty different OQMs were identified and appraised by 23 stakeholders. During the first survey, 14 OQMs were excluded and 6 qualified for discussion. During the face-to-face meeting, 10 stakeholders retained five OQMs and suggestions were made considering context and combination of metrics. The final set of metrics included defined daily doses, treatments/courses and prescriptions per defined population, treatments/courses and prescriptions per defined number of physician contacts and seasonal variation of total antibiotic use.
Conclusions:
A small set of consensually validated metrics to assess the quantity of antibiotic use in the outpatient setting was obtained, enabling (inter)national comparisons. The OQMs will help build a global conceptual framework for responsible antibiotic use.