Metrics to assess the quantity of antibiotic use in the outpatient setting: a systematic review followed by an international multidisciplinary consensus procedure

作者：Ann Versporten, Inge C. Gyssens, Céline Pulcini, Annelie A Monnier, Jeroen A. Schouten, Romina Milanič, Mirjana Stanić Benić, Gianpiero Tebano, Marion Le Maréchal, Veronica Zanichelli, Benedikt David Huttner, Vera Vlahović–Palčevski, Herman Goossens, Marlies Hulscher, Niels Adriaenssens, the DRIVE-AB WP1 group, Bojana Beovič, Luis Bavestrello, Jon D. Cohen, Pieter‐Jan Cortoos, Harpal S. Dhillon, Richard H. Drew, PRABHAVATHI B. FERNANDES, David M. Findlay, Ian R. Friedland, Ian Malcolm Gould, Lauri A. Hicks, Christopher M. Longshaw, Carl Llor, Allison McGeer, Iruka N. Okeke, Diamantis Plachouras, Garyphallia Poulakou, John H. Rex, Thomas Tängdén, Laura Trolle Saust, Claudine Richon, F. Roblot, Robert Vander Stichele, Marcel F. Verweij, Heiman F. L. Wertheim · 发表于：Journal of Antimicrobial Chemotherapy · 年份：2018 · DOI：10.1093/jac/dky119 · 被引用次数：45 · 研究领域：Antibiotic Use and Resistance、Healthcare cost, quality, practices、Health Systems, Economic Evaluations, Quality of Life

Background: The international Innovative Medicines Initiative (IMI) project DRIVE-AB (Driving Reinvestment in Research and Development and Responsible Antibiotic Use) aims to develop a global definition of 'responsible' antibiotic use. Objectives: To identify consensually validated quantity metrics for antibiotic use in the outpatient setting. Methods: First, outpatient quantity metrics (OQMs) were identified by a systematic search of literature and web sites published until 12 December 2014. Identified OQMs were evaluated by a multidisciplinary, international stakeholder panel using a RAND-modified Delphi procedure. Two online questionnaires and a face-to-face meeting between them were conducted to assess OQM relevance for measuring the quantity of antibiotic use on a nine-point Likert scale, to add comments or to propose new metrics. Results: A total of 597 articles were screened, 177 studies met criteria for full-text screening and 138 were finally included. Twenty different OQMs were identified and appraised by 23 stakeholders. During the first survey, 14 OQMs were excluded and 6 qualified for discussion. During the face-to-face meeting, 10 stakeholders retained five OQMs and suggestions were made considering context and combination of metrics. The final set of metrics included defined daily doses, treatments/courses and prescriptions per defined population, treatments/courses and prescriptions per defined number of physician contacts and seasonal variation of total antib...