Basic, Advanced, and Novel Metrics to Guide Antibiotic Use Assessments

Abstract

This review illustrates relevant and current antibiotic use (AU) metrics and demonstrates their differences. The authors also highlight novel, increasingly complex AU metrics proposed for use in antibiotic stewardship research. Many common antibiotic use metrics (e.g., days of therapy, length of therapy) are well defined, widely generalizable, and commonly used by antimicrobial stewardship programs. Multiple measures are required to comprehensively capture real-world AU, though utilization metrics often lack important contextual information needed to inform antibiotic stewardship strategy. Combining standard AU metrics with meaningful characterization of antibiotic prescriptions, including appropriateness of therapy or antibiotic spectrum, provides important information for developing strategy. Current antibiotic use metrics are limited by an inability to convey meaningful context. Future research should aim to define generalizable measures that illustrate improved prescribing in addition to volume of use.