How to measure the impacts of antibiotic resistance and antibiotic development on empiric therapy: new composite indices.

摘要: Objectives We aimed to construct widely useable summary measures of the net impact antibiotic resistance on empiric therapy. Summary are needed communicate importance resistance, plan and evaluate interventions, direct policy investment. Design, setting participants As an example, we retrospectively summarised 2011 cumulative antibiogram from a Toronto academic intensive care unit. Outcome developed two complementary indices summarise clinical drug availability The Empiric Coverage Index (ECI) susceptibility common bacterial infections available antibiotics as percentage. Options (EOI) varies 0 ‘the number treatment options available’, value current stock depletable resource. account for relative pathogens. demonstrate meaning use by examining potential new drugs threatening strains. Conclusions In our unit coverage device-associated measured ECI remains high (98%), but 37–44% EOI has been lost. Without reserved drugs, is 86–88%. New cephalosporin/β-lactamase inhibitor combinations could increase EOI, no single can compensate losses. Increasing methicillin-resistant Staphylococcus aureus (MRSA) prevalence would have little overall (ECI=98%, EOI=4.8–5.2) because many Gram-positives already resistant β-lactams. Aminoglycoside however, substantial they among few that provide Gram-negative (ECI=97%, EOI=3.8–4.5). Our proposed local using readily data. Policymakers developers help prioritise initiatives in effort against antimicrobial resistance.