Development of AWaRe antibiotic quality indicators for optimal use

Le résumé fourni par la source

Abstract Background The World Health Organization (WHO) AWaRe (Access/Watch/Reserve) book gives detailed guidance on the optimal use of antibiotics across primary care and hospitals for adults and children with the aim of improving the quality of use and reducing antimicrobial resistance. Objectives To develop model sets of appropriate and feasible quality indicators based on the WHO AWaRe system, that are widely implementable across primary care, hospital, and the health care system settings to support optimal antibiotic use. Methods Indicators from a scoping review were revised to focus on clinical infections in the AWaRe book. They were assessed using consensus techniques through two rounds each of the Global Delphi Technique and RAND/UCLA Appropriateness Method, evaluating appropriateness and feasibility at national and global levels respectively. In Round 1 of each method, panellists rated clarity and suggested revisions or new indicator. Round 2 results are reported. Findings The AWaRe QIs covered common primary and hospital infections listed in the AWaRe book and general patient and population level indicators. There were 102 quality indicators (Primary Care: 46; Hospital: 39; General: 17) included in Round 2 of the Delphi Technique and 136 indicators (Primary Care: 56; Hospital: 60; General: 20) in Round 2 of the RAND/UCLA method, which are presented as model sets of indicators. Conclusion These AWaRe model quality indicators can be locally adapted to support optimal use of antibiotics and inform global and national antimicrobial stewardship programs.

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