Benchmarking antimicrobial use to antimicrobial resistance: a comparative study of two hospitals using current National Healthcare Safety Network (NHSN) metrics.

IF 3 4区 医学 Q2 INFECTIOUS DISEASES
Carlos A Q Santos, Sarah Y Won, Ryan Dwyer, Caren Perez, William E Trick
{"title":"Benchmarking antimicrobial use to antimicrobial resistance: a comparative study of two hospitals using current National Healthcare Safety Network (NHSN) metrics.","authors":"Carlos A Q Santos, Sarah Y Won, Ryan Dwyer, Caren Perez, William E Trick","doi":"10.1017/ice.2024.210","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>We aimed to determine whether benchmarking antimicrobial use (AU) to antimicrobial resistance (AR) using select AU/AR ratios is more informative than AU metrics in isolation.</p><p><strong>Design: </strong>We retrospectively measured AU (antimicrobial therapy days per 1,000 days present) and AU/AR ratios (specific antimicrobial therapy days per corresponding AR event) in two hospitals during 2020 through 2022. We then had antimicrobial stewardship committee members evaluate each AU and corresponding AU/AR value and indicate whether they believed it represented potential overuse, appropriate use, or potential underuse of the antimicrobials, or whether they could not provide an assessment.</p><p><strong>Setting: </strong>Two acute-care hospitals.</p><p><strong>Patients: </strong>Hospitalized patients.</p><p><strong>Results: </strong>In semi-annual facility-wide analyses, echinocandins had a median AU/AR ratio of 658.5 therapy days per fluconazole-resistant <i>Candida</i> event in Hospital A, IV vancomycin had a median AU/AR ratio of 114.9 and 108.2 therapy days per methicillin-resistant <i>Staphylococcus aureus</i> event in Hospital A and B, respectively, and linezolid had a median AU/AR ratio of 33.8 and 88.0 therapy days per vancomycin-resistant <i>Enterococcus</i> event in Hospital A and B, respectively. When AU and AU/AR values were evaluated by stewardship committees, more respondents were able to assess antimicrobial use based on AU/AR values compared to AU values. Based on AU/AR ratios, most respondents identified potential overuse of echinocandins and IV vancomycin in Hospital A, and potential overuse of linezolid and IV vancomycin in Hospital B.</p><p><strong>Conclusion: </strong>Select AU/AR ratios provided informative metrics to antimicrobial stewardship personnel, which can be used to motivate audits of antimicrobial administration to determine appropriateness.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":3.0000,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infection Control and Hospital Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1017/ice.2024.210","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: We aimed to determine whether benchmarking antimicrobial use (AU) to antimicrobial resistance (AR) using select AU/AR ratios is more informative than AU metrics in isolation.

Design: We retrospectively measured AU (antimicrobial therapy days per 1,000 days present) and AU/AR ratios (specific antimicrobial therapy days per corresponding AR event) in two hospitals during 2020 through 2022. We then had antimicrobial stewardship committee members evaluate each AU and corresponding AU/AR value and indicate whether they believed it represented potential overuse, appropriate use, or potential underuse of the antimicrobials, or whether they could not provide an assessment.

Setting: Two acute-care hospitals.

Patients: Hospitalized patients.

Results: In semi-annual facility-wide analyses, echinocandins had a median AU/AR ratio of 658.5 therapy days per fluconazole-resistant Candida event in Hospital A, IV vancomycin had a median AU/AR ratio of 114.9 and 108.2 therapy days per methicillin-resistant Staphylococcus aureus event in Hospital A and B, respectively, and linezolid had a median AU/AR ratio of 33.8 and 88.0 therapy days per vancomycin-resistant Enterococcus event in Hospital A and B, respectively. When AU and AU/AR values were evaluated by stewardship committees, more respondents were able to assess antimicrobial use based on AU/AR values compared to AU values. Based on AU/AR ratios, most respondents identified potential overuse of echinocandins and IV vancomycin in Hospital A, and potential overuse of linezolid and IV vancomycin in Hospital B.

Conclusion: Select AU/AR ratios provided informative metrics to antimicrobial stewardship personnel, which can be used to motivate audits of antimicrobial administration to determine appropriateness.

求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
6.40
自引率
6.70%
发文量
289
审稿时长
3-8 weeks
期刊介绍: Infection Control and Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. Written by infection control practitioners and epidemiologists and guided by an editorial board composed of the nation''s leaders in the field, ICHE provides a critical forum for this vital information.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信