Indicators of the hospital use of antimicrobial agents based on consumption.

OBJECTIVE

To identify indicators of hospital use of antimicrobials from the  benchmark analysis of consumption data between hospitals at the same level  through the collective judgement of a group of experts.

METHOD

A committee formed by members of the Spanish Societies of Hospital Pharmacy and Infectious Diseases and Clinical Microbiology prepared a proposal of indicators which was submitted to  consensus by a panel of 21 experts on infectious diseases, microbiology and  antimicrobial therapy, through a modified Delphi method. The panel  underwent two rounds of scores by e-mail. Participants assigned a score  from 1 (completely disagree) to 9 (completely agree) to the relevance of  each indicator in four dimensions: scientific evidence, efficacy and safety,  ecological impact and cost. Scores were processed according to the RAND- UCLA method. An indicator was considered to be relevant if at least one  dimension other than cost obtained a median score equal to or higher than 7 without disagreement among the panel.

RESULTS

The committee submitted an initial proposal of 14 indicators. After the first round of panel scores, one indicator was ruled out and two  were  modified for moving on to the second round. Finally, 13 indicators  were considered relevant.

CONCLUSIONS

Determining indicators of the hospital use of antimicrobial agents based on consumption can allow the antimicrobial  stewardship programs to detect any potential problems with the use of  antimicrobial agents, and to help guide their efforts in order to implement actions of improvement, as well as to assess the impact of the  measures implemented.