TABLE 1

Definitions of quality indicators to monitor antibiotic use for all bacterial infections among hospitalized adult patients in non-ICU departments (adapted from the study by Van den Bosch et al. [12])

Quality indicatorNumeratoraDenominator
Empirical antibiotic therapy according
to local guidelines
No. of patients with EAT according to local guidelinesNo. of patients with EAT and clinical syndrome defined
in local guidelines
Adequate request for blood culturesNo. of patients with 2 sets of blood cultures before EAT initiationNo. of patients with systemic antibiotic treatment
Adequate request for blood culture from
site of infection
No. of patients with EAT and adequate request for blood culture
from site of infection
No. of patients with systemic antibiotic treatment
and cultivable infection
Antibiotic treatment directed to culture resultsNo. of patients with EAT directed to culture resultsNo. of patients with systemic antibiotic treatment and
positive culture results with clinical significance
Sequential antibiotic therapy within 72 hNo. of patients with antibiotic treatment for ≥72 h and clinical
stability with sequential antibiotic therapy
No. of patients who were candidates for sequential antibiotic therapy
Patients receiving unnecessary antibiotic
treatment in the absence of clinical or
microbiological evidence of infection
No. of patients with EAT receiving unnecessary antibiotic treatment
in the absence of clinical or microbiological evidence on the
fifth day of treatment
No. of patients with EAT for ≥5 days
Dosage adjusted for renal functionNo. of patients with eGFR of <50 ml/min/1.73 m2 and dosage
adjusted for renal function
No. of patients with systemic antibiotic treatment and eGFR of
<50 ml/min/1.73 m2
TDMNo. of patients with ≥1 determination of drug concentrationNo. of patients with treatment for ≥3 days with amikacin or
gentamicin and/or for ≥5 days with vancomycin
or targeted treatments
  • a EAT, empirical antibiotic therapy; eGFR, estimated glomerular filtration rate.