Table 2. Possible Metrics for Evaluation of Interventions to
Improve Antibiotic Use and Clinical Outcomes in
Patients with Specific Infectious Diseases Syndromes
Process Measures Outcome Measures
• Excess days of therapy (i.e.,
unnecessary days of therapy
avoided based on accepted targets
and benchmarks)
a
• Hospital length of stay
• Duration of therapy • 30-day mortality
• Proportion of patients compliant
with facility-based guideline or
treatment algorithm
a
• Unplanned hospital readmission within
30 days
• Proportion of patients with
revision of antibiotics based on
microbiolog y data
• Proportion of patients diagnosed with
hospital-acquired CDI or other adverse
events related to antibiotic treatment
a
• Proportion of patients converted
to oral therapy
• Proportion of patients with clinical failure
(e.g., need to broaden therapy, recurrence
of infection)
a
ese metrics are applicable for ASP interventions to reduce antibiotic treatment of
asymptomatic bacteriuria, which, in most cases, should not be treated, and therefore the
other metrics do not apply.
Special Populations
Î We suggest ASPs develop facility-specific guidelines for fever and
neutropenia management in hematology-oncology patients over no
such approach (W-L).
Î We suggest implementation of ASP interventions to improve
the appropriate prescribing of antifungal treatment in
immunocompromised patients (W-L).
Î In nursing homes and skilled nursing facilities, we suggest
implementation of antibiotic stewardship strategies to decrease
unnecessary use of antibiotics (GPR).
Î We suggest implementation of antibiotic stewardship interventions
to reduce inappropriate antibiotic and/or resistance in the neonatal
intensive care unit (GPR).
Î In terminally ill patients, we suggest ASPs provide support to clinical
care providers in decisions related to antibiotic treatments (GPR).
Measurement
