Comparison of antimicrobial utilization metrics: Food for thought for an antimicrobial stewardship programme

Chen, Jingshi; Ekaney, Irene; Shah, Punit J.

doi:10.1016/j.ijantimicag.2022.106681

Cited by 3 publications

(3 citation statements)

References 4 publications

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“…We have measured excess antibiotic use in DOTs, the preferred metric for antibiotic consumption, because unlike DDDs, DOTs are not influenced by differences in dosing due to body weight or renal/hepatic dysfunction 24. Assessment of appropriateness is at the discretion of the auditors and is subjective.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the appropriateness of antibiotic prescribing in an acute UK hospital using a national audit tool: a single centre retrospective survey

et al. 2023

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IntroductionAntibiotic use drives antibiotic resistance. The UK antimicrobial resistance (AMR) strategy aims to reduce antibiotic use. We aimed to quantify excess antibiotic use in a district general hospital in south-west England.MethodsMedical patients discharged in August 2020 who had received antibiotics were included. An audit tool of antibiotic prescribing appropriateness was used to collect relevant clinical information regarding each patient case. The appropriateness of antibiotic use was then determined by two infection specialists and excess days of therapy (DOTs) calculated.Results647 patients were discharged in August 2020. Of the 1658 antibiotic DOTs for the 184 patients reviewed, 403 (24%) were excess DOTs. The excess antibiotic DOTs were prescribed in 92 patients (50%); 112/403 (27.8%) excess DOTs originated at the initiation of antibiotic therapy (time point A); 184/403 (45.7%) of excess DOTs occurred at the antibiotic review pre-72 hours (time point B); and 107/403 (26.6%) of excess DOTs were due to protracted antibiotic courses (time point C).Conclusion24% of antibiotic DOTs were deemed unnecessary. The greatest opportunity to reduce antibiotic use safely was the pre-72 hours antibiotic review, which may provide a target for reducing excess antimicrobial therapy in line with the national AMR strategy.

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Section: Discussionmentioning

confidence: 99%

Assessment of the appropriateness of antibiotic prescribing in an acute UK hospital using a national audit tool: a single centre retrospective survey

et al. 2023

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“…Next, we expressed antibiotic consumption by DDD instead of days of therapy (DOT). According to a recent guideline for antibiotic stewardship programs, DOT is preferred to DDD as a measure of antibiotic consumption [37]. However, we could not use DOT because only the total amount of antibiotic consumption per patient was available.…”

Section: Discussionmentioning

confidence: 99%

Pattern of Antibiotic Use among Hospitalized Patients at a Level One Multidisciplinary Care Hospital

et al. 2023

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Background: Antimicrobial resistance is one of the world’s most serious health issues. Antibiotic resistance, excessive drug expense, and an increased risk of adverse reactions are all common outcomes of incorrect antibiotic prescribing. The goal of this study was to evaluate the prevalence of antibiotic prescriptions for inpatients to find areas for improvement. Methods: A retrospective study at Emergency Clinical County Hospital of Oradea, Romania was performed for five years between 2017 and 2021. Data was collected using medical records of the patients and reports from the pharmacy. Antibiotic consumption was expressed as DDD/100 BD according to the World Health Organization (WHO) by antibiotics, classes, and AWaRe classification. Results: The prevalence of antibiotic prescription was 53.8% during five years evaluated with a significant increase in 2021. A total of 13,677.42 DDD/100 BD antibiotics were prescribed, especially for surgical and medical prophylaxes. The most prescribed antibiotics were ceftriaxone, followed by metronidazole, and cefuroxime but there were some differences between years and wards. The most frequent antibiotic classes prescribed were cephalosporins (43.73%). The use of Watch Group antibiotics was high in all wards (59.69%). Conclusions: The prevalence of antibiotic use was high with cephalosporins being the most prescribed antibiotics. As a result, interventions are required.

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“…Antimicrobial consumption (AMC) is an essential metric for designing tailored antibiotic stewardship programs and for estimating their impact on drug utilization and resistance selection. It is also of value for target setting by policy makers [6].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Antimicrobial Consumption in Multi-Field Hospitals with Pediatric Inpatients: Conventional vs. Novel Pediatric-Adjusted Methodologies

Rachina,

Belkova,

Kozlov

et al. 2023

Antibiotics

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Background: the objective of this study was to propose a methodology for the assessment of antimicrobial consumption (AMC) in pediatric inpatients and to estimate variances in consumption levels in multi-field hospitals with pediatric inpatients, calculated by means of the pediatric-adjusted methodology vs. the conventional methodology. Methods: the pediatric-adjusted methodology based on the conventional ATC/DDD method and children’s DDDs (cDDD) for antimicrobials were proposed and validated in a series of probabilistic sensitivity analyses of real clinical data extracted from the receipt notes of three multi-field hospitals. Differences in AMC in multi-field hospitals with pediatric inpatients, calculated by means of the proposed methodology vs. the conventional methodology, were assessed for a virtual cohort of inpatients, with the pediatric share increasing by 1%. Results: in children ≤12 years old, assessment by the standard methodology resulted in a 59% underestimation of AMC from the levels based on prescribed doses, vs. a 25% underestimation for the proposed methodology. In a mixed-age virtual population of inpatients, the underestimation of consumption levels rose to 321% for the ATC/DDD methodology compared to the proposed one. Conclusions: the proposed methodology demonstrated a higher accuracy of AMC estimates compared to the conventional one and can be considered for the quantification of antimicrobial utilization in pediatric institutions and multi-field hospitals with a substantial share of pediatric inpatients.

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Comparison of antimicrobial utilization metrics: Food for thought for an antimicrobial stewardship programme

Cited by 3 publications

References 4 publications

Assessment of the appropriateness of antibiotic prescribing in an acute UK hospital using a national audit tool: a single centre retrospective survey

Assessment of the appropriateness of antibiotic prescribing in an acute UK hospital using a national audit tool: a single centre retrospective survey

Pattern of Antibiotic Use among Hospitalized Patients at a Level One Multidisciplinary Care Hospital

Assessment of Antimicrobial Consumption in Multi-Field Hospitals with Pediatric Inpatients: Conventional vs. Novel Pediatric-Adjusted Methodologies

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