Skip to main content

Table 4 Final set of quality indicators to monitor antimicrobial use in hospitalized adult patients with sepsis

From: Development of quality indicators for antimicrobial treatment in adults with sepsis

Indicator number from Table3 Quality indicator Numerator description Denominator description
  All patients are: hospitalized adult patients with sepsis, severe sepsis or septic shock, where systemic antimicrobial therapy must be started All patients are: hospitalized adult patients with sepsis, severe sepsis or septic shock, where systemic antimicrobial therapy must be started All patients are: hospitalized adult patients with sepsis, severe sepsis or septic shock, where systemic antimicrobial therapy must be started
Number 1. Antimicrobial therapy in adult patients with sepsis should be started intravenously. Number of patients who started with empirical systemic antimicrobial therapy intravenously. Total number of patients who started with empirical systemic antimicrobial therapy.
Number 2. Antimicrobial therapy should be started as soon as possible, preferably within the first hour in adult patients with severe sepsis and septic shock. Number of patients with severe sepsis or septic shock who started with empirical systemic antimicrobial therapy within the first hour after the clinical diagnosis. Total number of patients with severe sepsis or septic shock, who started with empirical systemic antimicrobial therapy.
Number 3. Before starting antimicrobial therapy, at least two sets of blood cultures and specimens for culture from suspected sites of infection should be taken. Number of patients from whom at least 2 blood cultures and specimens for culture from suspected sites of infection were taken before empirical systemic antimicrobial therapy was started. Total number of patients who started with empirical systemic antimicrobial therapy.
Number 45. Empiric systemic antimicrobial therapy should be changed to pathogen-directed therapy if culture results become available. Number of patients with a positive culture and empirical systemic antimicrobial therapy, which was changed to pathogen-directed therapy after the results became available. Total number of patients with empirical systemic antimicrobial therapy whose culture became positive.
Number 43 and number 42. Empiric systemic antimicrobial therapy (only choice of antimicrobial agent) should be prescribed according to the national guideline. The local guidelines should correspond to the national guideline, but should deviate based on local resistance patterns. Number of patients who started with empirical systemic antimicrobial therapy according to the national guideline. Total number of patients who started with empirical systemic antimicrobial therapy (only choice of antimicrobial agent).
   Number of hospitals with a local guideline that corresponds with the national guideline or only deviates based on local resistance patterns. Total number of hospitals with a local guideline.