Antimicrobial stewardship: 7a-Review of patients prescribed broad-spectrum antibiotics

Identifying and definitional attributes
Metadata item type:	Indicator
Indicator type:	Indicator
Short name:	Indicator 7a-Review of patients prescribed broad-spectrum antibiotics
METEOR identifier:	612226
Registration status:	Australian Commission on Safety and Quality in Health Care, Retired 25/01/2022 Health, Standard 12/09/2016
Description:	Proportion of admitted patients who were prescribed a broad-spectrum antibiotic and for whom a medical review is documented within 48 hours from the first prescription.
Rationale:	Unnecessary continuation of broad-spectrum antibiotics is associated with antimicrobial resistance. Culture results, including identification and antibiotic susceptibility test results, are usually available 24–48 hours after specimen collection. The results of these tests should be used to reassess the appropriateness of the initial therapy prescribed, along with the patient’s clinical progress and other investigation results (ACSQHC 2014a).
Indicator set:	Clinical care standard indicators: antimicrobial stewardship Australian Commission on Safety and Quality in Health Care, Retired 25/01/2022 Health, Standard 12/09/2016
Outcome area:	Use of broad-spectrum antibiotics Health, Standard 12/09/2016

Collection and usage attributes
Computation description:	For the numerator, ‘reviewed’ means that the clinician initials the microbiology result report (or in an electronic environment, there is evidence that the clinician has reviewed the result), and a treatment decision is documented within 48 hours from the first prescription. For the purposes of this indicator, ‘documented’ means there is a note about the treatment decision in the patient's prescription or medical record, which may be paper-based or electronic. For the numerator and denominator ‘broad-spectrum antibiotics’ refers to antibiotics that are active against a wide range of organisms (ACSQHC 2014b) and includes one or more of: meropenem, vancomycin, ciprofloxacin, ceftriaxone or piperacillin and tazobactam. Presented as a percentage.
Computation:	(Numerator ÷ denominator) x 100
Numerator:	Number of admitted patients for whom one or more broad-spectrum antibiotics were prescribed and for whom the microbiology results were reviewed.
Denominator:	Number of admitted patients for whom one or more broad-spectrum antibiotics were prescribed.
Representational attributes
Representation class:	Percentage
Data type:	Real
Unit of measure:	Service event
Format:	N[NN]
Source and reference attributes
Submitting organisation:	Australian Commission on Safety and Quality in Health Care
Reference documents:	ACSQHC (Australian Commission on Safety and Quality in Health Care) 2014a. Action 4: Review and assess antibiotics at 48 hours–Fact sheet. Sydney: ACSQHC. ACSQHC (Australian Commission on Safety and Quality in Health Care) 2014b. Antimicrobial Stewardship Clinical Care Standard. Sydney: ACSQHC.