### Antimicrobial use data

Antimicrobial use data are entered through the Antimicrobial use Form A/B tab. This form is opened by clicking the Antimicrobial use button in the Patients | Risk factors Form A/B tab.

Figure 11: The Antimicrobial use Form A/B tab

A unique antimicrobial record is defined by the fields with a bold label in the Antimicrobial use form. These fields create a unique combination of:

• ATC5 code + route + indication + diagnosis site (for treatment only – otherwise code NA=not applicable).

This means that it is possible to enter the same antimicrobial agent for more than one indication, for the treatment of more than one infection site, or for more than one route, in the same patient. De-duplication of the data will be done at the analysis level as necessary.

No warning message is given if the corresponding AU data are not entered in the AU form. These errors are only reported in the data quality check.

Typically you add patient data and antimicrobial consumption data, when you enter the survey data.

If data is incomplete, a Warning/Error message will open, listing required data items. Table 21 describes the variables in the Antimicrobial use form. Further details are provided in the HAI-Net PPS protocol (see Related documents).

To specify antimicrobial use data for a patient:

1. Click Patient/Antimicrobial use/HAI data in the main menu.

The Patients | Risk factors form opens displaying the Form A/B tab.

2. Scroll through the list of patients to locate the patient you are interested in and confirm that the patient details match the patient whose data you want to update.

3. Select Yes for the Patient receives antimicrobial(s) field to activate the Antimicrobial Use button.

4. Click Antimicrobial use.

The Antimicrobial use Form A/B tab (Figure 11) opens.

5. Click Search by brand.

The Search by brand form opens.

6. Enter the brand name in the field or click the required brand in the list.

7. Click Select this brand.

You return to the Antimicrobial use form, where the ATC5 code and route have been inserted.

8. Optionally, click the User tab to view or edit the antimicrobial use user variables.

9. Click the Save icon or press Ctrl+S.

Descriptions of the variables in the Antimicrobial use General tab are given in Table 21. Mandatory fields are indicated by a red asterisk *. Required fields are indicated by a black asterisk *.

Table 21: Antimicrobial use Form A/B tab variables

Variable | Description
Header section | From ward PPS data (Table 19) and PPS patient risk data (Table 20).
ANTIMICROBIAL (ATC5) * | Antimicrobial generic or brand name. Allowed are, for example, amoxicillin, but also national brand names; include ATC codes (ATC2: J01 antibacterials, J02 antifungals; ATC4: A07AA, P01AB, D01BA; ATC5: J04AB02). See codebook for included antimicrobial agents.
Route * | Route of administration of the antimicrobial agent; P=parenteral; O=oral; R=rectal; I=inhalation.
Brand name | Retrieved from stored brand names.
Indication * | Patient receives systemic antimicrobials for: • Treatment intention: CI: community-acquired infection; LI: infection acquired in long-term care facility (e.g. nursing home) or chronic-care hospital; HI: acute-hospital-acquired infection. • Surgical prophylaxis: SP1: single dose; SP2: one day; SP3: > 1 day: check if given in the 24 hours prior to 8 a.m. on the day of the survey – if yes, check if given on the day before yesterday or on the day of the survey in order to determine duration. • MP. Medical prophylaxis. • O. Other indication (e.g. erythromycin use as a prokinetic agent). • UI. Unknown indication/reason (verified during PPS). • UNK. Unknown/missing, information on indication was not verified during PPS. If treatment intention for infection, fill in site of infection (diagnosis).
Diagnosis (site) * | Diagnosis group by anatomical site. Should only be recorded if there is an intention to treat an infection; not recorded for prophylaxis or other indications (use code NA=not applicable). See codebook for code list.
Reason in notes * | The reason for antimicrobial use was documented in the patient chart/notes. Yes/No/Unknown.
Date start antimicrobial | Start date of the current antimicrobial. If the patient received the antimicrobial on admission, record the date of admission.
Was antimicrobial changed? (+reason) | Was the antimicrobial (or the route of administration) changed for this indication, and if so, what was the reason? If the antimicrobial was changed more than once for the current indication, report the reason of the last change. • N=no change, antimicrobial was not changed. • E=Escalation: antimicrobial was escalated on microbiological and/or clinical grounds, i.e. the isolated microorganism was not susceptible to the previous antimicrobial and/or lack of clinical effect of previous antimicrobial; includes switch from oral to parenteral for the same antimicrobial. • D=De-escalation: antimicrobial was de-escalated on microbiological and/or clinical grounds, i.e. the isolated microorganism was susceptible to more narrow-spectrum or first-line antimicrobials than the previous antimicrobial and/or the clinical situation of the patient allows changing to more narrow-spectrum or first-line antimicrobial. • S=switch IV to oral; route of administration of same antimicrobial was changed from parenteral to oral. • A=adverse effects; antimicrobial was changed because of observed or expected side or adverse effects of the antimicrobial. • OU=change for other or unknown reason: the antimicrobial for that indication was changed for another reason or the antimicrobial was changed but the reason why could not be determined by the surveyor. • U=unknown: no information on whether the antimicrobial was changed or not.
If changed; date start first antimicrobial for this indication | Start date of the first antimicrobial prescribed before the current antimicrobial for the same indication if the current antimicrobial replaced a previous one. If the antimicrobial was changed more than once for the current indication, report the start date of the first (not the previous) antimicrobial.
Dosage per day | Number and strength (in milligrams, grams, IU or MU) of doses of the antimicrobial given per day. Report as e.g. 4 x 1 g per day (three variables: number of doses, strength of one dose, unit of one dose). When one dose of an antimicrobial is given every other day, report the number of doses as 0.5 (e.g. 0.5 x 1 g/day).

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HAI data

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