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

Antimicrobial Resistance & Infection Control

Song Mi Moon¹  Bongyoung Kim²  Myung Jin Lee³  Hong Bin Kim⁴  Kyoung-Ho Song⁴  Eu Suk Kim⁴  Se Yoon Park⁵  Tae Hyong Kim⁵ 

[1] Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea;Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea;Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea;Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea;Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, 59, Daesagwan-ro, Yongsan-gu, 140-743, Seoul, Republic of Korea;

关键词: Quality indicator;    Anti-bacterial agents;    Antibiotic prophylaxis;    Bacterial infection;   

DOI  :  10.1186/s13756-021-00913-y

来源: Springer

【 摘 要 】

BackgroundAn 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.MethodsA 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.ResultsThe 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 QIs to prescribe antibiotics according to the guideline and initiate antibiotic therapy 1 h before incision were selected.ConclusionsWe identified key QIs to measure the appropriateness of antibiotic therapy to identify targets for improvement and to evaluate the effects of antibiotic stewardship intervention.

【 授权许可】

CC BY