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. 2019 Aug 24;8(3):127. doi: 10.3390/antibiotics8030127

Table 5.

Global metrics of overall healthcare system performance.

Global Metrics Description
Incidence rate of hospital-onset Clostridioides difficile infection
  • Indirect assessment of quantity and spectrum of AU in healthcare facilities

  • Tool for evaluation of IPCPs, clinical decision support programs, laboratory, and diagnostic stewardship

Incidence rate of ESBLE infections or colonization
  • ESBLE predominantly cause community-onset infections in North America and Europe

  • Better metric for ambulatory ASPs and IPCPs than inpatient ASPs

  • Rates are influenced by prior colonization

Incidence rate of MRSA infections or colonization
  • MRSA has emerged as community-onset bacteria as well

  • Association between MRSA and AU is not very clear

  • Measures performance of IPCPs more than ASPs

Sepsis or bloodstream infection case-fatality rate
  • Evaluates clinical, diagnostic, and interventional critical care skills; clinical decision support programs; and laboratory diagnostics, including microbiology

  • ASPs may influence only one of many variables that determine outcome, that is, empirical antimicrobial therapy through institutional management guidelines and other interventions

Cost of healthcare
  • Antimicrobial cost is a fraction of total healthcare cost

  • ASPs may indirectly contribute to reduction in healthcare cost by reducing length of hospital stay through selection of appropriate empirical antimicrobial therapy and reducing risk of antimicrobial adverse events such as acute kidney injury and C. difficile infection

Note: ASP: antimicrobial stewardship programs; AU: antimicrobial utilization; ESBLE: extended-spectrum beta-lactamase-producing Enterobacteriaceae; IPCP: infection prevention and control program.