The question which indicator should be chosen is inconclusive for the evaluation of the selection pressure exerted by an antibiotic. The two indicators proposed in the newsletter (observed indicator and calculated indicator) seem to be complementary for use in a regional or national network to monitor resistance and consumption of antibiotics. Each hospital should validate the indicators and define for itself which indicator is most appropriate for estimating the actual length of antibiotic exposure. This may imply different indicators for different units, antibiotics or even administration routes within one particular hospital setting. Once validated the hospital has a powerful tool generating data that can be linked to resistance data.
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