Implementation of an antibiotic checklist increased appropriate antibiotic use in the hospital on Aruba

Abstract

Objectives: No interventions have yet been implemented to improve antibiotic use on Aruba. In the Netherlands, the introduction of an antibiotic checklist resulted in more appropriate antibiotic use in nine hospitals. The aim of this study was to introduce the antibiotic checklist on Aruba, test its effectiveness, and evaluate the possibility of implementing this checklist outside the Netherlands.

Methods: The antibiotic checklist includes seven quality indicators (QIs) that define appropriate antibiotic use. It applies to adult patients with a suspected bacterial infection, treated with intravenous antibiotics. The primary endpoint was the QI sum score, calculated by the patient's sum of performed checklist-items divided by the total number of QIs that applied to that specific patient. Outcomes before and after the introduction of the checklist were compared.

Results: The percentage of patients with a QI sum score ≥50% increased significantly during the intervention (n=173) compared to baseline (n=150) (odds ratio 3.67, p<0.001). However, performance did not improve on each individual QI. The checklist was used in 63.3% of the eligible patients.

Conclusions: The introduction of the antibiotic checklist increased appropriate antibiotic use on Aruba. Additional initiatives are necessary for further improvement per QI. These results suggest that the antibiotic checklist could be used internationally.

Keywords: Antibiotic stewardship; Checklist; Intervention; Quality indicators.