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Table 1 Final lists of potential key quality indicators

From: Development of key quality indicators for appropriate antibiotic use in the Republic of Korea: results of a modified Delphi survey

Nos. Potential key quality indicators
QI 1 Empirical systemic antibiotic therapy should be prescribed according to the institutional, national, or international guideline
QI 2 Before starting systemic antibiotic therapy, at least two sets of blood cultures should be taken
QI 3 When starting systematic antibiotic therapy, specimens for culture from suspected sites of infection should be taken as soon as possible, preferably before antibiotics are started
QI 4 An antibiotic plan should be documented in the case notes at the start of systemic antibiotic therapy
QI 5 Systemic antibiotic therapy should be switched from i.v. to oral antibiotic therapy within 48–72 h on the basis of the clinical condition and when oral treatment is adequate
QI 6 Empirical antibiotic therapy should be changed to pathogen-directed therapy if culture results become available
QI 7 Dose and dosing interval of systemic antibiotic therapy should be adapted to renal function
QI 8 Therapeutic drug monitoring should be performed when the therapy duration is > 3 days for aminoglycosides and > 5 days for vancomycin
QI 9 Empirical antibiotic therapy for presumed bacterial infection should be discontinued based on the lack of clinical and/or microbiological evidence of infection. The maximum duration of empirical systemic antibiotic treatment should be 7 days
QI 10 Surgical prophylaxis antibiotic therapy should be prescribed according to guideline
QI 11 Surgical prophylaxis antibiotic therapy should be initiated within 1 h before incision
QI 12 Surgical prophylaxis antibiotic therapy should be discontinued within 1 day
QI 13 Antibiotic therapy in adult patients with sepsis should be started intravenously
QI 14 Contraindications (history of allergy, anaphylaxis, or toxicity) should be taken into account when prescribing antibiotics
QI 15 Acute upper respiratory infections and bronchitis should not be treated with antibiotics within the first 3 days, unless there is documented indication for treatment
QI 16 Antibiotics should be prescribed within appropriate cost
QI 17 Antibiotics should be prescribed in appropriate duration
QI 18 Antibiotics with anaerobic activity combination of two or more antimicrobials
QI 19 Outpatients with acute tonsillitis/pharyngitis should undergo a group A streptococcal diagnostic test to decide whether or not they should receive antibiotics
QI 20 Follow up cultures 4–7 days after initial blood culture positivity (bloodstream infection due to Staphylococcus aureus and fungi)
QI 21 Documented significant single-organism bacteriuria
QI 22 Perform ID specialist bedside consultation in hospitalized patient
QI 23 Appropriate pharmacokinetics
  1. These potential quality indicators are final version after Delphi procedure
  2. QI quality indicator