Table 3. Final list of actionable quality indicators and quantity metric to monitor appropriate antibiotic use for bacterial infections in hospitalized adult patients admitted at the ICU.

	Quality Indicator	Indicator type	Definition	Numerator	Denominator	Target value
1	Perform blood cultures before start of antibiotic therapy	Process	Percentage of patients in whom at least two sets of blood cultures were performed before start of empirical systemic therapy	Number of patients in whom at least 2 sets of blood cultures were performed between 24 hours before and 24 hours after empirical systemic antibiotic therapy was started	Total number of patients who started with empirical systemic antibiotic therapy	100%
2	Perform therapeutic drug monitoring in patients treated with vancomycin or aminoglycosides, within 48 hours	Process	Percentage of patients treated with vancomycin or aminoglycosides in whom drug levels were determined within 48 hours after start of antibiotic therapy	Number of patients treated with vancomycin or aminoglycosides in whom drug levels were determined within 48 hours after start of antibiotic therapy	Total number of patients treated with vancomycin or aminoglycosides therapy for at least 48 hours	100%
3	Perform surveillance cultures when SDD or SOD is applied	Process	Percentage of patients in whom surveillance cultures were obtained if selective digestive or oropharyngeal decontamination is applied at the ICU	Number of patients in whom at least one surveillance culture was obtained from rectum, throat and airways when selective digestive or oropharyngeal decontamination is applied at the ICU	Total number of patients in whom selective digestive or oropharyngeal decontamination is applied at the ICU	100%
4	Biannual face-to -face meetings between IC staff and microbiology staff in which local resistance rates are discussed	Structure	Face-to-face meetings between IC staff and microbiology staff in which local resistance rates and trends in the ICU population are discussed.	-	-	At least 2 times per year
	Quantity metric	Definition				Target value
5	Quantitative antibiotic use expressed in DOT	Quantitative antibiotic use at the ICU expressed in days of therapy (DOT) per 100 patient-days or per 100 admissions Specified for subgroups: 1) restricted antibiotics, 2) per diagnosis				No target value. The metric provides context for indicators and is suitable for benchmarking