{"title":"Application of center for disease control and prevention standardized antimicrobial administration ratio to an Indian hospital.","authors":"Smita Sarma, Kalyani Borde, Matthew Robinson, Neelam Rawat, Prerna Khurana, Vyoma Singh, Padam Singh, Yatin Mehta","doi":"10.1017/ash.2024.396","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Rigorous antibiotic stewardship is advised by international societies to combat rising antibiotic resistance. A major component of these programs is the metric used for antibiotic consumption measurement. A method for standardized antimicrobial administration ratio (SAAR) is suggested by the Centre for Disease Control & Prevention-National Healthcare Safety Network (NHSN).</p><p><strong>Objectives: </strong>We applied the SAAR method to calculate antibiotic consumption in a tertiary care hospital in India. We also validated a limited sampling approach to calculate SAAR.</p><p><strong>Method: </strong>The prospective study was conducted in three medical intensive care units over a period of 12 months. Monthly antibiotic consumption was measured by the hospital electronic records. Limited sampling was performed by weekly bedside review of the antibiotic orders. Formulae for SAAR calculation were derived from the NHSN guide. SAAR obtained by electronic records and limited sampling were compared to validate this approach.</p><p><strong>Results: </strong>SAAR was calculated as >1 for an Indian hospital (1.49 by electronic records and 1.43 by limited sampling approach). The difference between the two ratios was not statistically significant (<i>P</i> = .47).</p><p><strong>Conclusions: </strong>SAAR in our setting is 1.49, which is slightly higher than the NHSN benchmark. Antibiotic usage (AU) risk adjustment based on data from the NHSN might not be adequate for calculating SAAR for Indian hospitals. There is a need to perform AU risk factor analysis for Indian settings for better defining SAAR in Indian context. The limited sampling approach can be adapted for calculation of SAAR in settings with limited resources.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440567/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Antimicrobial stewardship & healthcare epidemiology : ASHE","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1017/ash.2024.396","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Rigorous antibiotic stewardship is advised by international societies to combat rising antibiotic resistance. A major component of these programs is the metric used for antibiotic consumption measurement. A method for standardized antimicrobial administration ratio (SAAR) is suggested by the Centre for Disease Control & Prevention-National Healthcare Safety Network (NHSN).
Objectives: We applied the SAAR method to calculate antibiotic consumption in a tertiary care hospital in India. We also validated a limited sampling approach to calculate SAAR.
Method: The prospective study was conducted in three medical intensive care units over a period of 12 months. Monthly antibiotic consumption was measured by the hospital electronic records. Limited sampling was performed by weekly bedside review of the antibiotic orders. Formulae for SAAR calculation were derived from the NHSN guide. SAAR obtained by electronic records and limited sampling were compared to validate this approach.
Results: SAAR was calculated as >1 for an Indian hospital (1.49 by electronic records and 1.43 by limited sampling approach). The difference between the two ratios was not statistically significant (P = .47).
Conclusions: SAAR in our setting is 1.49, which is slightly higher than the NHSN benchmark. Antibiotic usage (AU) risk adjustment based on data from the NHSN might not be adequate for calculating SAAR for Indian hospitals. There is a need to perform AU risk factor analysis for Indian settings for better defining SAAR in Indian context. The limited sampling approach can be adapted for calculation of SAAR in settings with limited resources.
背景:国际学会建议采取严格的抗生素管理措施,以应对不断上升的抗生素耐药性。这些计划的一个重要组成部分是用于衡量抗生素消耗量的指标。美国疾病控制与预防中心-国家医疗安全网络(NHSN)提出了一种标准化抗菌药物给药比率(SAAR)的方法:我们在印度的一家三级医院采用 SAAR 方法计算抗生素消耗量。我们还验证了计算 SAAR 的有限抽样方法:这项前瞻性研究在三家医疗重症监护病房进行,为期 12 个月。每月抗生素消耗量通过医院电子记录进行测量。每周对抗生素医嘱进行床旁审查,从而进行有限抽样。计算 SAAR 的公式来自 NHSN 指南。对电子记录和有限抽样获得的 SAAR 进行比较,以验证这种方法:一家印度医院的 SAAR 计算结果大于 1(电子记录为 1.49,有限抽样为 1.43)。两个比率之间的差异无统计学意义(P = .47):我们的 SAAR 为 1.49,略高于 NHSN 基准。基于 NHSN 数据的抗生素使用(AU)风险调整可能不足以计算印度医院的 SAAR。有必要对印度的情况进行抗生素使用风险因素分析,以便更好地定义印度的 SAAR。在资源有限的情况下,可以采用有限抽样的方法来计算 SAAR。