Linda D Dresser1,2, Chaim M Bell1,3,4,5, Marilyn Steinberg3, Niall D Ferguson1,3,4, Stephen Lapinsky3,4, Neil Lazar1,4, Patricia Murphy1,6, Jeffrey M Singh1,4, Andrew M Morris1,3,4. 1. University Health Network, 101 College St., Toronto, Ontario M5G 1L7, Canada. 2. Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College St., Toronto, Ontario M5S 3M2, Canada. 3. Sinai Health System, 600 University Ave., Toronto, Ontario M5G 1X5, Canada. 4. Department of Medicine, University of Toronto, 200 Elizabeth St., Suite RFE 3-805, Toronto, Ontario M5G 2C4, Canada. 5. Institute for Clinical Evaluative Sciences, 2075 Bayview Ave., G1-06, Toronto, Ontario M4N 3M5, Canada. 6. Department of Anesthesia, University of Toronto, 123 Edward St., Room 1200, Toronto, Ontario M5G 1E2, Canada.
Abstract
BACKGROUND: Antimicrobial prescribing is frequently reported as appropriate or inappropriate, particularly in the ICU. However, the definitions used are non-standardized and lack validity and reliability. OBJECTIVES: To develop standardized definitions of appropriateness for antimicrobial prescribing in the critical care setting. METHODS: We used consensus-based modified Delphi and RAND appropriateness methodology to develop criteria to define appropriateness of antimicrobial prescribing. A multiphased approach with an online questionnaire followed by a facilitated in-person meeting was utilized and included clinicians from a variety of practice areas (e.g. surgeons, infectious diseases specialists, intensivists, transplant specialists and pharmacists). RESULTS: There were a total of 23 criteria agreed upon to define the following categories of antimicrobial prescribing: appropriate; effective but unnecessary; inappropriate; and under-treatment. CONCLUSIONS: These standardized criteria for appropriateness may be generalizable to other patient populations and utilized with other tools to adjudicate prescribing practices.
BACKGROUND: Antimicrobial prescribing is frequently reported as appropriate or inappropriate, particularly in the ICU. However, the definitions used are non-standardized and lack validity and reliability. OBJECTIVES: To develop standardized definitions of appropriateness for antimicrobial prescribing in the critical care setting. METHODS: We used consensus-based modified Delphi and RAND appropriateness methodology to develop criteria to define appropriateness of antimicrobial prescribing. A multiphased approach with an online questionnaire followed by a facilitated in-person meeting was utilized and included clinicians from a variety of practice areas (e.g. surgeons, infectious diseases specialists, intensivists, transplant specialists and pharmacists). RESULTS: There were a total of 23 criteria agreed upon to define the following categories of antimicrobial prescribing: appropriate; effective but unnecessary; inappropriate; and under-treatment. CONCLUSIONS: These standardized criteria for appropriateness may be generalizable to other patient populations and utilized with other tools to adjudicate prescribing practices.
Authors: Linda Dresser; Madeleine S Stephen; Mark McIntyre; Linda Jorgoni; Sarah C J Jorgensen; Sandra Nelson; Chaim Bell; Andrew M Morris Journal: BMJ Open Qual Date: 2020-11
Authors: Rodney James; Yoshiko Nakamachi; Andrew Morris; Miranda So; Sasheela Sri La Sri Ponnampalavanar; Pem Chuki; Ly Sia Loong; Pauline Siew Mei Lai; Caroline Chen; Robyn Ingram; Arjun Rajkhowa; Kirsty Buising; Karin Thursky Journal: JAC Antimicrob Resist Date: 2022-02-09
Authors: Margherita Macera; Federica Calò; Lorenzo Onorato; Giovanni Di Caprio; Caterina Monari; Antonio Russo; Anna Galdieri; Antonio Giordano; Patrizia Cuccaro; Nicola Coppola Journal: Life (Basel) Date: 2021-05-24