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IPAC News: Ask the Expert


How do local antimicrobial stewardship programs (ASPs) evaluate their impact?

Response provided by Alice Hogg, Justin Cook, Christel Johanson and Sumit Raybardhan, Pharmacist Consultants with Public Health Ontario.

Each ASP must decide which evaluation measures are most appropriate based on its own activities.

Most institutions report process measurements that quantify the effect of the individual ASP. For example, if intravenous to oral conversion is a focus, the ASP should measure the rate of conversion. If guidelines have been implemented, the ASP should evaluate the rate of guideline adherence.

The effect of the ASP on institutional antimicrobial use is often measured, and overall antibiotic consumption is useful for benchmarking. Defined daily dose (DDD) is endorsed by the World Health Organization, but current consensus in North America prefers days of therapy (DOT). 

Focusing on cost savings alone is not recommended, since factors outside the ASP can affect costs and any savings are likely to represent only an initial impact.

Outcome measures such as mortality, length of stay and antimicrobial resistance rates are useful, but they may be confounded by external factors as well. These factors are not easily accounted for and may limit the applicability of such metrics.

For more information on these and other ASP measures, see the PHO metrics and evaluations presentation and the PHO metrics and evaluations document.



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Page last updated: 2014-11-12 1:43 PM
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