Developing a framework for regular and sustainable qualitative assessment of antibiotic use in Korean medical institutions: a Delphi study

Abstract

Background We aimed to develop a roadmap for conducting regular, sustainable, and strategic qualitative assessments of antibiotic use in medical institutions within the Republic of Korea. Methods A literature review on the current state of qualitative antibiotic assessments was conducted, followed by one open round to collect ideas, two scoring rounds to establish consensus, and one panel meeting between them. The expert panel comprised 20 experts in infectious disease or antibiotic stewardship. Results The response rate for all three surveys was 95% (19/20), while the panel meeting attendance rate was 90% (18/20). The following long-term goals were defined to assess the annual use of antibacterial and antifungal agents in all medical institutions, including clinics. The panel agreed that random sampling of antibiotic prescriptions was the most suitable method of selecting antibiotics for qualitative assessment, with the additional possibility of evaluating specific antibiotics or infectious diseases that warrant closer evaluation for promoting appropriate antibiotic use. The plan for utilization of results from evaluation involves providing feedback while maintaining anonymity and disclosure. It includes a quantitative assessment of antibiotic prescriptions and resistance rates to compare against institutional benchmarks. Furthermore, it was agreed to link the evaluation findings to the national antibiotic stewardship programme, enabling policy and institutional approaches to address frequently misused items, identified during the evaluation. Conclusion This study provides a framework for establishing a qualitative assessment of antimicrobial use for medical institutions at a national level in the Republic of Korea.

Implementing antimicrobial stewardship: lessons and perspectives from a university-affiliated tertiary hospital in Korea

“…Nonetheless, it is important to tailor ASP interventions to institutional needs, with a focus on the operating team [ 36 , 37 ]. While our hospital implemented antibiotic computerized restrictive antibiotic prescription system from its inception, we observed no significant change in antibiotic use.…”

“…Considering that Korean medical institutions lack medical resources, it is difficult to simultaneously implement qualitative evaluation-based ASP interventions. Qualitative evaluations and interventions based on the recently proposed quality indicators in Korea may be a sustainable alternative in such circumstances [ 36 , 37 ]. It is important to apply a stepwise implementation strategy—which should be led by a dedicated AMS Team—tailored to the institution.…”

Principles and practices of antimicrobial stewardship programs in Korea

“…In addition to quantitative monitoring by KONAS, a consistent qualitative evaluation of antibiotic use is crucial. Identifying inappropriate antibiotic prescriptions for infectious diseases by monitoring the quality of antibiotic use is essential for the effective implementation of antibiotic stewardship [ 18 , 25 ].…”