Antimicrobial Stewardship Programs: Appropriate Measures and Metrics to Study their Impact

Area of Science:

• Healthcare Management
• Infectious Diseases
• Public Health

Background:

• Antimicrobial stewardship is a critical but evolving field focused on optimizing antimicrobial use.
• Effective antimicrobial stewardship programs (ASPs) require robust metrics to demonstrate their impact on healthcare systems and patient populations.
• Measuring the success of ASPs is challenging due to the complexity and variety of available metrics.

Approach:

• Evaluating antimicrobial consumption metrics, including defined daily doses, days of therapy, and costs per 1,000 patient-days.
• Assessing point prevalence surveys as a replicable method for understanding antimicrobial use without complex electronic systems.
• Examining appropriateness measures, noting their potential but current limitations in widespread applicability.

Key Points:

• Antimicrobial use metrics are common but offer different insights with unique advantages and disadvantages.
• Antimicrobial resistance, while a primary driver for stewardship, presents measurement challenges and may not directly reflect intervention success.
• Patient outcome measures, such as mortality and cure rates, are crucial but require careful interpretation.

Conclusions:

• No single metric perfectly captures the multifaceted impact of antimicrobial stewardship programs.
• A balanced approach integrating antimicrobial use, resistance patterns, and patient outcomes is essential for comprehensive ASP evaluation.
• Further development of standardized and reliable metrics is needed to enhance the assessment and effectiveness of antimicrobial stewardship initiatives.