Clinimetric properties and suitability of selected quality indicators for assessing antibiotic use in hospitalized adults: A multicentre point prevalence study in 24 hospitals in Germany

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Gesche Först - , University of Freiburg (Author)
  • Winfried V. Kern - , University of Freiburg (Author)
  • Nadine Weber - , University of Freiburg (Author)
  • Christiane Querbach - , Technical University of Munich (Author)
  • Johannes Kleideiter - , University Hospital Bielefeld (Author)
  • Holger Knoth - , Pharmacy, University Hospital Carl Gustav Carus Dresden (Author)
  • Stefan Hagel - , Friedrich Schiller University Jena (Author)
  • Andreas Ambrosch - , Barmherzige Brüder Hospital Regensburg (Author)
  • Micha Löbermann - , Rostock University Medical Centre (Author)
  • Philipp Schröder - , German Federal Armed Forces Hospital Ulm (Author)
  • Johannes Borde - , University of Freiburg, Ortenau Klinikum Achern (Author)
  • Michaela Steib-Bauert - , University of Freiburg (Author)
  • Katja De With - , Clinical Infectious Disease Unit, University Hospital Carl Gustav Carus Dresden (Author)

Abstract

Objectives: The capability to measure and monitor the quality of antibiotic prescribing is an important component of antibiotic stewardship (ABS) programmes. Several catalogues of consensus-based structure and process-of-care quality indicators (QIs) have been proposed, but only a few studies have tested and validated ABS QIs in practice tests. This multicentre study determined the clinimetric properties and suitability of a set of 33 process QIs for ABS that had earlier been developed and in part recommended in a German-Austrian hospital ABS practice guideline. Methods: Two point prevalence surveys were conducted in a convenience sample of 24 acute care hospitals throughout Germany, and data of all screened adult inpatients with prescription of a systemic antibiotic at a given day (n=4310) were included in the study. For each QI, the following clinimetric properties were assessed: applicability, feasibility, performance, case mix stability and interobserver reliability. Results: Eighteen QIs were considered sufficiently feasible, applicable and reliable, and had adequate room for improvement. The finally selected QIs primarily cover antibiotic therapy of common infections (bloodstream infection, pneumonia and urinary tract infection), while two of the QIs each address surgical prophylaxis and general aspects of antibiotic administration. Conclusions: Practice tests may be important to test the suitability of consensus process-of-care QIs in the field of hospital ABS. The 18 selected QIs considered suitable enough for hospital ABS in this study should be regarded as priority QIs useful for internal quality control and assurance. More research and additional practice tests may be needed to confirm their suitability for external quality assessment schemes.

Details

Original languageEnglish
Pages (from-to)3596-3602
Number of pages7
JournalJournal of Antimicrobial Chemotherapy
Volume74
Issue number12
Publication statusPublished - 1 Dec 2019
Peer-reviewedYes

External IDs

PubMed 31504603
ORCID /0000-0001-9473-3018/work/148606209