The ability to measure the quality of antibiotic prescriptions is a critical element in all antimicrobial stewardship programs. The aims of the present study were to evaluate the clinimetric properties of 32 recently developed outpatient quality indicators (OQIs) and to identify potential room for improvement in antibiotic use in a primary health care (PHC) area. The study was performed in a PHC area in Barcelona, Spain with 260,657 inhabitants, nine PHC centers, and a 400-bed acute-care teaching hospital. We selected 9 of the 32 OQIs that were applicable to our PHC area and evaluated them for measurability, adherence, and room for improvement. Nonmeasurable OQIs, OQIs without room for improvement, and OQIs beyond the scope of the PHC antimicrobial stewardship program were excluded. Data from 260,561 registered patients were assessed. Measurability was high for all OQIs except those that required manual recording of the clinical diagnosis (OQIs on group A streptococcal diagnostic testing). Adherence to guidelines was poor for most OQIs, but particularly for the indicator on the avoidance of antibiotics for viral or self-limiting bacterial infections, where we observed more than 60% room for improvement for both acute tonsillitis and sinusitis. The QIs evaluated were applicable to clinical practice and proved useful for identifying areas with room for improvement in our setting and for guiding the design of future interventions with specific objectives.

中文翻译：

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门诊质量指标在初级卫生保健领域适当使用抗生素的适用性：点流行度调查。

衡量抗生素处方质量的能力是所有抗菌素管理计划中的关键要素。本研究的目的是评估32个最近开发的门诊质量指标（OQI）的临床质量，并确定初级保健（PHC）领域抗生素使用的潜在改善空间。该研究是在西班牙巴塞罗那的PHC地区进行的，该地区有260,657名居民，9个PHC中心和400张病床的急救教学医院。我们从32种OQI中选择了9种适用于我们的PHC领域，并评估了它们的可测量性，依从性和改进空间。不可衡量的OQI，无改进空间的OQI和超出PHC抗菌素管理计划范围的OQI均被排除在外。评估了260561名注册患者的数据。除了需要手动记录临床诊断的OQI（A组链球菌诊断测试中的OQI）以外，所有OQI的可测量性都很高。对于大多数OQI，对指南的依从性很差，尤其是对于避免针对病毒性或自限性细菌感染的抗生素的指标，我们观察到急性扁桃体炎和鼻窦炎的改善空间超过60％。所评估的质量指标适用于临床实践，并被证明有助于确定我们的环境中仍有待改进的地方，并可以指导设计具有特定目标的未来干预措施。但尤其是在避免针对病毒性或自限性细菌感染的抗生素的指标方面，我们观察到急性扁桃体炎和鼻窦炎的改善空间超过60％。所评估的质量保证适用于临床实践，并被证明有助于确定有待改进的地方，并指导设计具有特定目标的未来干预措施。但尤其是在避免针对病毒性或自限性细菌感染的抗生素的指标方面，我们观察到急性扁桃体炎和鼻窦炎的改善空间超过60％。所评估的质量指标适用于临床实践，并被证明有助于确定我们的环境中仍有待改进的地方，并可以指导设计具有特定目标的未来干预措施。