Evaluating the appropriateness of antimicrobial treatment in hospitalized patients: a comparison of three methods
| Autor: | K Amarney, E Tannous, Michal Stein, M Assaly, S Reisfeld |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine Microbiology (medical) medicine.medical_specialty Adolescent Hospitalized patients 030106 microbiology Young Adult 03 medical and health sciences Drug Utilization Review 0302 clinical medicine Cohen's kappa Internal medicine Evaluation methods Humans Medicine 030212 general & internal medicine Young adult Aged Quality of Health Care Aged 80 and over Inpatients business.industry Health services research General Medicine Middle Aged Antimicrobial Hospitals Anti-Bacterial Agents Infectious Diseases Female Health Services Research business Kappa |
| Zdroj: | Journal of Hospital Infection. 99:127-132 |
| ISSN: | 0195-6701 |
| Popis: | Summary Background Approximately 20–50% of antimicrobial therapy in hospitalized patients is considered inappropriate, which may be associated with increased morbidity and mortality. The best method for evaluation of appropriateness is not well defined. Aim To evaluate the rate of appropriate antimicrobial therapy in a secondary hospital using three different methods, and determine the rate of agreement between the different methods. Methods A point prevalence study included all adult hospitalized patients receiving systemic antimicrobial therapy during 2016, screened on a single day. Clinical, laboratory and therapeutic data were collected from patient files, and appropriateness was rated with a qualitative evaluation by expert opinion. In addition, a quantitative evaluation was performed according to 11 quality indicators (QIs) rated for each patient. A strict definition of appropriateness was fulfilled if six essential QIs were met, and a lenient definition was fulfilled if at least five QIs were met. Agreement between methods was analysed using kappa statistic. Findings Among 106 patients included, rates of appropriateness of antimicrobial therapy ranged from 20% to 75%, depending on the method of evaluation. Very low agreement was found between the strict definition and expert opinion (kappa=0.068), and medium agreement was found between the lenient definition and expert opinion (kappa=0.45). Conclusions Rates of appropriateness of antimicrobial therapy varied between evaluation methods, with low to moderate agreement between the different methods. |
| Databáze: | OpenAIRE |
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