Inapropriate use of antibiotics effective against gram positive microorganisms despite restrictive antibiotic policies in ICUs: a prospective observational study

Table 1 The Quality Parameters for Inappropriate use of antibiotics

Abbreviations	Criteria	Assessment Day	Non-Compliance Definition	References
IUC-1	Antibiotic Treatment Indication Doumented rationale for starting antibiotics in patients charts	1st day	No provide rationale of antibiotics	[9]
IUC-2	Appropriate microbiological sampling - At least 2 sets of blood culture -Culture from suspected infection site -Time for taking culture samples	1st day	Inadequate blood or suspected-infection site culture Collection of culture after antibiotic administration	[3, 10, 11]
IUC-3	Antibiotic Dosage -Antibiotic dose according to body weight -Loading dosage use^a -Adjustment of dosage according to the glomerular filtration rate (GFR)^b	1st, 3st and 7st day	-Less than the recommended dose according to body weight or body mass index -No loading dose^a -No antibiotic dose adjustment according to GFR	[12]
IUC-4	De-escalation^{c, d, e} Discontinuation of antibiotic therapy based on microbiological results	3st and 7st day	Continuation of antibiotic therapy based on lack of antimicrobiological evidence	[3, 10, 11]
IUC-5	Duration of treatment^f Discontinuation of antibiotic therapy according to local or international guidelines	14st and 21^st day	-Longer treatment than recommended -Shorter treatment than recommended	[13,14,15,16]

Abbreviations: IUC Inappropriate use criteria
^aEvaluated for vancomycin and teicoplanin
^bCalculated with GFR cockroft formula
^cThe incubation time for samples other than blood cultures is 2 days and for blood samples a minimum of 5 days. For this reason, deescalation evaluation was performed on the 3rd and 7th days of treatment
^dDe-escalation assessment was only performed for empirical antibiotic treatment
eDe-escalation evaluation was not performed in patients whose treatment duration was less than 7 days
^fDe-escalation or withdrawal of the patient (discharge, transfer, death, etc.) has not been evaluated for treatment duration

ISSN: 1471-2334