title: Antimicrobial use metrics and benchmarking to improve stewardship outcomes: methodology, opportunities, and challenges.
abstract: Measurement of antimicrobial use before and after an intervention and the associated outcomes are key activities of antimicrobial stewardship programs. In the United States, the recommended metric for aggregate antibiotic use is days of therapy/1000 patient-days. Clinical outcomes, including response to therapy and bacterial resistance, are critical measures but are more difficult to document than economic outcomes. Interhospital benchmarking of risk adjusted antimicrobial use is possible, although several obstacles remain before it can have an impact on patient care. Many challenges for stewardship programs remain, but the methods and science to support their efforts are rapidly evolving.
authors.affiliation: Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, 1225 Center Drive, Gainesville, FL 32611, USA.
authors.forename: Omar M
authors.initials: OM
authors.lastname: Ibrahim
authors.affiliation: Department of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University/Medical College of Virginia Campus, 410 North 12th Street, Richmond, VA 23298, USA. Electronic address: rpolk@vcu.edu.
authors.forename: Ron E
authors.initials: RE
authors.lastname: Polk
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D019985:Benchmarking / Q000379:methods*; D003695:Delivery of Health Care / Q000592:standards*; D024881:Drug Resistance, Bacterial; D017723:Drug Utilization Review / Q000379:methods*; D006761:Hospitals; D006801:Humans; D008792:Metric System
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic epidemiology; Antibiotic metrics; Antibiotic resistance; Antibiotic stewardship; Antibiotic use; Benchmarking