155. Development of antibiotic classification for measuring antibiotic usage in Korean hospitals using a modified Delphi method

BACKGROUND: In 2019, the project about developing a system for measure and benchmark antibiotic usage in each hospital was launched. As the basic work for the project, we developed ‘antibiotic classification for measuring antibiotic usage in Korean hospitals’ using a modified Delphi method. Consensual definition of antibiotic components according to the antibiotic classification in Korean hospitals. [Image: see text] METHODS: The study consisted of two series of modified Delphi studies and was performed from July to August 2019. The study ‘antibiotic classification in Korean hospitals’ was performed first and followed by the study ‘antibiotic components according to the antibiotic classification in Korean hospitals’. Each Delphi study included two rounds of surveys in order to gather opinions and refine the information related to each study. We recruited a total of 12 panels including infectious diseases physicians (10), professor of preventive medicine (1), and the researcher of Health Insurance Review & Assessment Service (1). The questions for the Round 1 survey in each study were adopted from the antibiotic classification of the NHSN. RESULTS: As for the first study, the response rate of each round was 58.3% (7/12) and 75.0% (9/12), respectively. Most of the subjects of the NHSN’s antibiotic classification for adults were accepted except ‘antibacterial agents posing the highest risk for Clostridioides difficile infection’ (CVR = -1.000). On the contrary, all subjects for children were rejected. Finally, a total of 6 classifications were accepted. They were i) broad-spectrum antibacterial agents predominantly for hospital-onset infections, for adult (CVR = 1.000), ii) broad-spectrum antibacterial agents predominantly used for community-acquired infections, for adult (CVR = 1.000), iii) antibacterial agents predominantly used for resistant gram-positive infections, for adult (CVR =1.000), iv) narrow-spectrum beta-lactam agents, for adult (CVR = 1.000), v) antibacterial agents predominantly used for extensive antibiotic resistant gram-negative bacteria, for adult (CVR = 1.000), and vi) total antibacterial agent (CVR = 1.000). CONCLUSION: this study provides antibiotic classification for measuring antibiotic usage in Korean hospitals. This classification may guide to develop a system for measuring of antibiotic usage in each Korean hospital. DISCLOSURES: All Authors: No reported disclosures