Next Article in Journal
Staphylococcus aureus Infections in Malaysia: A Review of Antimicrobial Resistance and Characteristics of the Clinical Isolates, 1990–2017
Next Article in Special Issue
Bacteriophages as Alternatives to Antibiotics in Clinical Care
Previous Article in Journal / Special Issue
The Perfect Bacteriophage for Therapeutic Applications—A Quick Guide
Review

Direct Measurement of Performance: A New Era in Antimicrobial Stewardship

1
School of Medicine, University of South Carolina, Columbia, SC 29209, USA
2
Department of Medicine, Division of Infectious Diseases, Palmetto Health University of South Carolina Medical Group, Columbia, SC 29203, USA
3
Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina College of Pharmacy, Columbia, SC 29208, USA
4
Department of Pharmacy, Prisma Health Richland, Columbia, SC 29203, USA
*
Author to whom correspondence should be addressed.
Received: 18 July 2019 / Revised: 20 August 2019 / Accepted: 21 August 2019 / Published: 24 August 2019
(This article belongs to the Special Issue Feature Paper in Antibiotics for 2019)
For decades, the performance of antimicrobial stewardship programs (ASPs) has been measured by incidence rates of hospital-onset Clostridioides difficile and other infections due to multidrug-resistant bacteria. However, these represent indirect and nonspecific ASP metrics. They are often confounded by factors beyond an ASP’s control, such as changes in diagnostic testing methods or algorithms and the potential of patient-to-patient transmission. Whereas these metrics remain useful for global assessment of healthcare systems, antimicrobial use represents a direct metric that separates the performance of an ASP from other safety and quality teams within an institution. The evolution of electronic medical records and healthcare informatics has made measurements of antimicrobial use a reality. The US Centers for Disease Control and Prevention’s initiative for reporting antimicrobial use and standardized antimicrobial administration ratio in hospitals is highly welcomed. Ultimately, ASPs should be evaluated based on what they do best and what they can control, that is, antimicrobial use within their own institution. This narrative review critically appraises existing stewardship metrics and advocates for adopting antimicrobial use as the primary performance measure. It proposes novel formulas to adjust antimicrobial use based on quality of care and microbiological burden at each institution to allow for meaningful inter-network and inter-facility comparisons. View Full-Text
Keywords: Antibiotics; resistance; broad-spectrum agents; hospital epidemiology; antibiotic utilization; infection control; infection prevention; Pseudomonas aeruginosa; Acinetobacter baumannii; extended-spectrum beta-lactamases; carbapenem-resistant Enterobacteriaceae; methicillin-resistant Staphylococcus aureus Antibiotics; resistance; broad-spectrum agents; hospital epidemiology; antibiotic utilization; infection control; infection prevention; Pseudomonas aeruginosa; Acinetobacter baumannii; extended-spectrum beta-lactamases; carbapenem-resistant Enterobacteriaceae; methicillin-resistant Staphylococcus aureus
Show Figures

Figure 1

MDPI and ACS Style

Al-Hasan, M.N.; Winders, H.R.; Bookstaver, P.B.; Justo, J.A. Direct Measurement of Performance: A New Era in Antimicrobial Stewardship. Antibiotics 2019, 8, 127. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8030127

AMA Style

Al-Hasan MN, Winders HR, Bookstaver PB, Justo JA. Direct Measurement of Performance: A New Era in Antimicrobial Stewardship. Antibiotics. 2019; 8(3):127. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8030127

Chicago/Turabian Style

Al-Hasan, Majdi N.; Winders, Hana R.; Bookstaver, P. B.; Justo, Julie A. 2019. "Direct Measurement of Performance: A New Era in Antimicrobial Stewardship" Antibiotics 8, no. 3: 127. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8030127

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Search more from Scilit
 
Search
Back to TopTop