Implementation of an antibiotic checklist increased appropriate antibiotic use in the hospital on Aruba

Daalen, Frederike V. van; Lagerburg, Anouk; Kort, Jaclyn De; Rivas, Elena Sànchez; Geerlings, Suzanne E.

doi:10.1016/j.ijid.2017.03.019

Cited by 7 publications

(4 citation statements)

References 26 publications

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“…Beyond capturing the state of antibiotic use, the implementation of QIs may also aid in measuring how far an intervention impacts the quality antibiotic use. 27,28 Measurement in the quality of antibiotic use has long been part of the routine practice in Indonesia. However, to date, the widely used audit method in Indonesia is the Gyssens flow chart, which was developed by Gyssens et.…”

Section: Discussionmentioning

confidence: 99%

The Clinimetric Profile of 11 Generic Quality Indicators for Appropriate Antibiotic Use in Hospitalized Patients in Indonesia

Tunjungputri,

Lie,

Susilo

et al. 2023

Preprint

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BackgroundOne of the efforts in antibiotic stewardship for limiting antibiotic resistance is the assessment of the quality of antibiotic use. To date, the quality and appropriateness of antibiotic use in Indonesia, a low-middle-income non-European country, have not yet been assessed using proven quality indicators (QIs). One recommended tool to measure appropriate empiric antibiotic use in hospitalized patients is the generic QIs reported by van den Boschet. al., which demonstrated good validity and generalizability.ObjectiveThe aim of this study is to assess the clinimetric profile of 11 generic QIs based on van den Boschet. al. in admitted adult patients receiving empiric antibiotics in Indonesian hospitals.MethodsThis is an observational study with a cross-sectional design conducted at two government referral hospitals in Jakarta, Indonesia, from August 1, 2022, to February 2, 2023. Adult inpatients who received empiric antibiotics due to suspected infection for ≥24 hours were included in the study.ResultsIn 500 inpatients from 2 hospitals, all QIs demonstrated good measurability with less than 10% of missing data. Ten QIs showed good applicability of >10%. Four QIs show good performance, while six QIs have significant potential for improvement (two blood cultures are obtained before empiric antibiotic treatment; culture sample is obtained from location suspected of infection; antibiotic is switched from intravenous to oral when clinically possible; antibiotics are stopped when there is no evidence of infection; a guideline is available and renewed every three years; and a guideline is adjusted to the local resistance pattern) making them priority targets for interventions to enhance the quality of antibiotic use in Indonesia. All QIs display good inter-observer reliability, and no moderate or strong correlations are found between QIs.ConclusionThe clinimetric assessment of QIs is imperative before their implementation in any setting different from their country of origin. Of the 11 generic QIs, 10 demonstrated good reliability and applicability at two hospitals in Indonesia. Future intervention studies can utilize these generic QIs to measure improvement in the appropriateness of antibiotic use.

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Section: Discussionmentioning

confidence: 99%

The Clinimetric Profile of 11 Generic Quality Indicators for Appropriate Antibiotic Use in Hospitalized Patients in Indonesia

Tunjungputri,

Lie,

Susilo

et al. 2023

Preprint

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“…13 Antibiotic checklist can also be promising tool to reduce unnecessary use of antibiotics in clinical practice. 14,15 AMR and rational use of antibiotic: Is there any solution? Several reports have been published in recent years that outline measures to reduce the consumption of antibiotics.…”

Section: Rational Use Of Antibioticsmentioning

confidence: 99%

“…But considering the situation of increasing AMR and lack of new tool to combat the situation, infection prevention and control would be the primary target, rather than treating infection. 14,15 Reduction of antibiotics use without a prescription will have significant effect in controlling AMR. If necessary, local government must come forward with appropriate legislation and strict implementation.…”

Section: Rational Use Of Antibioticsmentioning

confidence: 99%

Rational Use of Antibiotics

Hasan

Mamun

2023

Dhaka Shishu (Child) Hosp. J.

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“…The systematic literature search identi ed 4293 articles, of which only 21 articles were nally selected after screening against the inclusion/exclusion criteria (Supplemental Table 1) [6,7,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. From these 21 articles, we initially derived 192 QIs.…”

Section: Literature Search and Selection Of Potential Key Qismentioning

confidence: 99%

Development of key quality indicators for appropriate antibiotic use in the Republic of Korea: results of a modified Delphi survey

Kim

Park

et al. 2020

Preprint

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Background: An effective antibiotic stewardship program relies on the measurement of appropriate antibiotic use, on which there is a lack of consensus. We aimed to develop a set of key quality indicators (QIs) for nationwide point surveillance in the Republic of Korea.Methods: A systematic literature search of PubMed, EMBASE, and Cochrane Library (publications until 20th November 2019) was conducted. Potential key QIs were retrieved from the search and then evaluated by a multidisciplinary expert panel using a RAND-modified Delphi procedure comprising two online surveys and a face-to-face meeting. Results: The 23 potential key QIs identified from 21 studies were submitted to 25 multidisciplinary expert panels, and 17 key QIs were retained, with a high level of agreement (13 QIs for inpatients, 7 for outpatients, and 3 for surgical prophylaxis). After adding up the importance score and applicability, six key QIs [6 QIs (Q 1–6) for inpatients and 3 (Q 1, 2, and 5) for outpatients] were selected: (1) prescribe empirical antibiotic therapy according to guideline, (2) change empirical antibiotics to pathogen-directed therapy, (3) obtain culture samples from suspected infection sites, (4) obtain two blood cultures, (5) adapt antibiotic dosage to renal function, and (6) document antibiotic plan. In surgical prophylaxis, the QI to prescribe antibiotics according to the guideline and initiate antibiotic therapy 1 h before incision was selected.Conclusions: We identified key QIs to measure the appropriateness of antibiotic therapy for the identification of targets for improvement and to evaluate effects of antibiotic stewardship intervention.

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Implementation of an antibiotic checklist increased appropriate antibiotic use in the hospital on Aruba

Abstract: The introduction of the antibiotic checklist increased appropriate antibiotic use on Aruba. Additional initiatives are necessary for further improvement per QI. These results suggest that the antibiotic checklist could be used internationally.

Cited by 7 publications

References 26 publications

The Clinimetric Profile of 11 Generic Quality Indicators for Appropriate Antibiotic Use in Hospitalized Patients in Indonesia

The Clinimetric Profile of 11 Generic Quality Indicators for Appropriate Antibiotic Use in Hospitalized Patients in Indonesia

Rational Use of Antibiotics

Development of key quality indicators for appropriate antibiotic use in the Republic of Korea: results of a modified Delphi survey

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