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

Antimicrobial Resistance and Infection Control

Korea Study Group for Antimicrobial Stewardship (KOSGAP)¹  Song Mi Moon²  Bongyoung Kim³  Myung Jin Lee⁴  Eu Suk Kim⁵  Hong Bin Kim⁵  Kyoung-Ho Song⁵  Se Yoon Park⁶  Tae Hyong Kim⁶ 

[1] ;Department of Internal Medicine, Hallym University Sacred Heart Hospital;Department of Internal Medicine, Hanyang University College of Medicine;Department of Internal Medicine, Inje University Sanggye Paik Hospital;Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine;Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine;

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

DOI  :  10.1186/s13756-021-00913-y

来源: DOAJ

【 摘 要 】

Abstract 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 QIs to prescribe antibiotics according to the guideline and initiate antibiotic therapy 1 h before incision were selected. Conclusions We 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】

Unknown