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Table 3 Ranking of final selected key quality indicators for admitted and outpatients and applicability in point surveillance study

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

Quality indicators Inpatients Outpatients
Ranking Total score Applicability Ranking Total score Applicability
QI 1. Empirical systemic antibiotic therapy should be prescribed according to the institutional, national, or international guideline 1 114 Yes 1 114 Yes
QI 6. Empirical antibiotic therapy should be changed to pathogen-directed therapy if culture results become available 2 109 Yes 2 109 Yes
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 3 103 Yes    
QI 2. Before starting systemic antibiotic therapy, at least two sets of blood cultures should be taken 4 100 Yes    
QI 7. Dose and dosing interval of systemic antibiotic therapy should be adapted to renal function 5 96 Yes 3 96 Yes
QI 17. Antibiotics should be prescribed in appropriate duration 6 92 No 4 92 No
QI 4. An antibiotic plan should be documented in the case notes at the start of systemic antibiotic therapy 7 89 Yes    
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 8 88 No 5 88 No
QI 14. Contraindications (history of allergy, anaphylaxis, or toxicity) should be taken into account when prescribing antibiotics 9 87 No 6 87 No
QI 18. Antibiotics with anaerobic activity combination of two or more antimicrobials 10 84 No    
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 11 82 No    
QI 20. Follow up cultures 4–7 days after initial blood culture positivity (bloodstream infection due to Staphylococcus aureus and fungi) 12 69 No    
QI 8. Therapeutic drug monitoring should be performed when the therapy duration is > 3 days for aminoglycosides and > 5 days for vancomycin 13 52 No 7 84 No
  1. QI quality indicator