Author ORCID Identifier
Document Type
Article
Publication Date
11-27-2020
Abstract
The complexities of antibiotic resistance mean that successful stewardship must consider both the effectiveness of a given antibiotic and the spectrum of that therapy to minimize imposing further selective pressure. To meet this challenge, we propose the Desirability of Outcome Ranking approach for the Management of Antimicrobial Therapy (DOOR MAT), a flexible quantitative framework that evaluates the desirability of antibiotic selection. Herein, we describe the steps required to implement DOOR MAT and present examples to illustrate how the desirability of treatment selection can be evaluated using resistance information. While treatments and the scoring of treatment selections must be adapted to specific clinical settings, the principle of DOOR MAT remains constant: The most desirable antibiotic choice effectively treats the patient while exerting minimal pressure on future resistance.
Keywords
antibiotic stewardship, antimicrobial resistance, methodology
Language
English
Publication Title
Clinical Infectious Diseases
Grant
R01AI063517
Rights
Published by Oxford University Press for the Infectious Diseases Society of America 2020. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Recommended Citation
Brigid M Wilson, Yunyun Jiang, Robin L P Jump, Roberto A Viau, Federico Perez, Robert A Bonomo, Scott R Evans, Desirability of Outcome Ranking for the Management of Antimicrobial Therapy (DOOR MAT): A Framework for Assessing Antibiotic Selection Strategies in the Presence of Drug Resistance, Clinical Infectious Diseases, Volume 73, Issue 2, 15 July 2021, Pages 344–350, https://doi.org/10.1093/cid/ciaa1769
Manuscript Version
Final Publisher Version