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Title: | Quality indicators assessing antibiotic use in the outpatient setting: a systematic review followed by an international multidisciplinary consensus procedure | Authors: | Le Marechal, Marion Tebano, Gianpiero MONNIER, Annelie Adriaenssens, Niels GYSSENS, Inge Huttner, Benedikt Milanic, Romina Schouten, Jeroen Benic, Mirjana Stanic Versporten, Ann Vlahovic-Palcevski, Vera Zanichelli, Veronica Hulscher, Marlies E. Pulcini, Celine |
Issue Date: | 2018 | Publisher: | OXFORD UNIV PRESS | Source: | JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 73(S6), p. 40-49 | Abstract: | Objectives: Quality indicators (QIs) assessing the appropriateness of antibiotic use are essential to identify targets for improvement and guide antibiotic stewardship interventions. The aim of this study was to develop a set of QIs for the outpatient setting from a global perspective. Methods: A systematic literature review was performed by searching MEDLINE and relevant web sites in order to retrieve a list of QIs. These indicators were extracted from published trials, guidelines, literature reviews or consensus procedures. This evidence-based set of QIs was evaluated by a multidisciplinary, international group of stakeholders using a RAND-modified Delphi procedure, using two online questionnaires and a face-to-face meeting between them. Stakeholders appraised the QIs' relevance using a nine-point Likert scale. This work is part of the DRIVE-AB project. Results: The systematic literature review identified 43 unique QIs, from 54 studies and seven web sites. Twenty-five stakeholders from 14 countries participated in the consensus procedure. Ultimately, 32 QIs were retained, with a high level of agreement. The set of QIs included structure, process and outcome indicators, targeting both high- and middle-to low-income settings. Most indicators focused on general practice, addressing the common indications for antibiotic use in the community (particularly urinary and respiratory tract infections), and the organization of healthcare facilities. Twelve indicators specifically addressed outpatient parenteral antimicrobial therapy (OPAT). Conclusions: We identified a set of 32 outpatient QIs to measure the appropriateness of antibiotic use. These QIs can be used to identify targets for improvement and to evaluate the effects of antibiotic stewardship interventions. | Notes: | [Le Marechal, Marion; Tebano, Gianpiero; Pulcini, Celine] Univ Lorraine, APEMAC, F-54000 Nancy, France. [Monnier, Annelie A.; Gyssens, Inge C.] Radboud Univ Nijmegen, Med Ctr, Dept Internal Med, Nijmegen, Netherlands. [Monnier, Annelie A.; Schouten, Jeroen; Hulscher, Marlies E.] Radboud Univ Nijmegen, Med Ctr, Radboud Inst Hlth Sci, Sci Ctr Qual Healthcare IQ Healthcare, Nijmegen, Netherlands. [Monnier, Annelie A.; Gyssens, Inge C.] Hasselt Univ, Res Grp Immunol & Biochem, Fac Med, Hasselt, Belgium. [Adriaenssens, Niels; Versporten, Ann] Univ Antwerp, Lab Med Microbiol, Vaccine & Infect Dis Inst VAXINFECTIO, Antwerp, Belgium. [Adriaenssens, Niels] Univ Antwerp, Dept Primary & Interdisciplinary Care ELIZA, Ctr Gen Practice, Antwerp, Belgium. [Huttner, Benedikt; Zanichelli, Veronica] Geneva Univ Hosp & Fac Med, Infect Control Program, Geneva, Switzerland. [Huttner, Benedikt] Geneva Univ Hosp & Fac Med, Div Infect Dis, Geneva, Switzerland. [Milanic, Romina; Benic, Mirjana Stanic; Vlahovic-Palcevski, Vera] Univ Rijeka, Univ Hosp Rijeka, Dept Clin Pharmacol, Rijeka, Croatia. [Milanic, Romina; Benic, Mirjana Stanic; Vlahovic-Palcevski, Vera] Univ Rijeka, Med Fac, Rijeka, Croatia. [Pulcini, Celine] Univ Lorraine, CHRU Nancy, Infect Dis Dept, F-54000 Nancy, France. | Document URI: | http://hdl.handle.net/1942/27357 | ISSN: | 0305-7453 | e-ISSN: | 1460-2091 | DOI: | 10.1093/jac/dky117 | ISI #: | 000434940500006 | Rights: | Copyright The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2019 |
Appears in Collections: | Research publications |
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