1. Informing the development of a standardised approach to measure antibiotic use in secondary care: a systematic review protocol
- Author
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Susan Hopkins, Laura Shallcross, Selina Patel, and Arnoupe Jhass
- Subjects
antibiotic resistance ,MEDLINE ,Context (language use) ,secondary care ,high resource ,antibiotic use ,03 medical and health sciences ,Antimicrobial Stewardship ,0302 clinical medicine ,Antibiotic resistance ,medicine ,Protocol ,Antimicrobial stewardship ,Humans ,030212 general & internal medicine ,Practice Patterns, Physicians' ,Protocol (science) ,0303 health sciences ,Measure (data warehouse) ,030306 microbiology ,business.industry ,Equity (finance) ,Drug Resistance, Microbial ,General Medicine ,Bacterial Infections ,Reference Standards ,medicine.disease ,3. Good health ,Anti-Bacterial Agents ,Research Design ,Scale (social sciences) ,Data Interpretation, Statistical ,Medical emergency ,Public Health ,business ,Systematic Reviews as Topic - Abstract
IntroductionEcological and individual-level evidence indicates that there is an association between level of antibiotic exposure and the emergence and spread of antibiotic resistance. The Global Point Prevalence Survey in 2015 estimated that 34.4% of hospital inpatients globally received at least one antimicrobial. Antimicrobial stewardship to optimise antibiotic use in secondary care can reduce the high risk of patients acquiring and transmitting drug-resistant infections in this setting. However, differences in the availability of data on antibiotic use in this context make it difficult to develop a consensus of how to comparably monitor antibiotic prescribing patterns across secondary care. This review will aim to document and critically evaluate methods and measures to monitor antibiotic use in secondary care.Methods and analysisWe will search Medline (Ovid), Embase (Ovid), Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials and websites of key organisations for published reports where an attempt to measure antibiotic usage among adult inpatients in high-income hospital settings has been made. Two independent reviewers will screen the studies for eligibility, extract data and assess the study quality using the Newcastle-Ottawa scale. A description of the methods and measures used in antibiotic consumption surveillance will be presented. An adaptation of the Affordability, Practicability, Effectiveness, Acceptability, Side-effects Equity framework will be used to consider the practicality of implementing different approaches to measuring antibiotic usage in secondary care settings. A descriptive comparison of definitions and estimates of (in)appropriate antibiotic usage will also be carried out.Ethics and disseminationEthical approval is not required for this study as no primary data will be collected. The results will be published in relevant peer-reviewed journals and presented at relevant conferences or meetings where possible. This review will inform future approaches to scale up antibiotic consumption surveillance strategies to attempt to maximise impact through standardisation.PROSPERO registration numberCRD42018103375
- Published
- 2019