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A Concise Set of Structure and Process Indicators to Assess and Compare Antimicrobial Stewardship Programs Among EU and US Hospitals: Results From a Multinational Expert Panel

  • Lori A. Pollack (a1), Diamantis Plachouras (a2), Ronda Sinkowitz-Cochran (a1), Heidi Gruhler (a1), Dominique L. Monnet (a2), J. Todd Weber (a1) and Transatlantic Taskforce on Antimicrobial Resistance (TATFAR) Expert Panel on Stewardship Structure and Process Indicators...



To develop common indicators, relevant to both EU member states and the United States, that characterize and allow for meaningful comparison of antimicrobial stewardship programs among different countries and healthcare systems.


Modified Delphi process.


A multinational panel of 20 experts in antimicrobial stewardship.


Potential indicators were rated on the perceived feasibility to implement and measure each indicator and clinical importance for optimizing appropriate antimicrobial prescribing.


The outcome was a set of 33 indicators developed to characterize the infrastructure and activities of hospital antimicrobial stewardship programs. Among them 17 indicators were considered essential to characterize an antimicrobial stewardship program and therefore were included in a core set of indicators. The remaining 16 indicators were considered optional indicators and included in a supplemental set.


The integration of these indicators in public health surveillance and special studies will lead to a better understanding of best practices in antimicrobial stewardship. Additionally, future studies can explore the association of hospital antimicrobial stewardship programs to antimicrobial use and resistance.

Infect Control Hosp Epidemiol 2016:1–11


Corresponding author

Address correspondence to Lori A. Pollack, MD, MPH, 4770 Buford Hwy, NE, Mailstop F-76, Atlanta, GA 30341 (


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Presented in part: The European Congress of Clinical Microbiology and Infectious Diseases meeting; April 2015; Copenhagen; and the International Conference on Prevention & Infection Control meeting; June 2015; Geneva; and posted as part of the Update Summary of TATFAR Recommendations on the CDC TATFAR website in July 2015.

Members of the TATFAR Expert Panel on Stewardship Structure and Process Indicators are listed at the end of the text.



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A Concise Set of Structure and Process Indicators to Assess and Compare Antimicrobial Stewardship Programs Among EU and US Hospitals: Results From a Multinational Expert Panel

  • Lori A. Pollack (a1), Diamantis Plachouras (a2), Ronda Sinkowitz-Cochran (a1), Heidi Gruhler (a1), Dominique L. Monnet (a2), J. Todd Weber (a1) and Transatlantic Taskforce on Antimicrobial Resistance (TATFAR) Expert Panel on Stewardship Structure and Process Indicators...


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