Selection of indicators for continuous monitoring of the impact of programs optimizing antimicrobial use in Primary Care

Objectives: To determine core indicators for monitoring quality prescribing in Primary Care based on the evidence, and to assess the feasibility of these indicators for monitoring the use of antibiotics. Methods: A literature review was carried out on quality indicators for antimicrobial prescribing through an electronic search limited to the period 2001-2012. It was completed with an ad hoc search on the websites of public national and international health services. Finally, indicators were chosen by consensus by a multidisciplinary group of professionals, dedicated to managing infections from several areas. The feasibility and applicability of these indicators was verified through the reporting and use of data in the prescription database. Results: Twenty two indicators were found. The consensus group selected 16 indicators. Eleven of them measure the specific antimicrobial selection, and 5 are consumption rates. The indicators were successfully applied to the prescription database, being able to make comparisons between different geographical areas and to observe trends in prescriptions. Conclusion: The definition of a basic set of indicators to monitor antibiotic use adapted to local conditions is required. The results of these indicators can be used for feedback to professionals and for evaluating the impact of programs aimed at improving antimicrobial use. (C) 2014 Elsevier Espana, S.L.U. and Sociedad Espanola de Enfermedades Infecciosas y Microbiologia Clinica. All rights reserved.