Antibiotic Stewardship
Frequently Asked Questions about Entering your Antibiotic Start Data
What is new with the antibiotic start reporting program?
There are many changes to the antibiotic start reporting program starting in 2025. First, the online survey tool is now hosted on REDCap. They survey looks different and functions differently. The new online tool collects additional data, including prescribing indication for antibiotic starts and demographics of the prescribed resident. In order to collect these data, antibiotic starts are reported individually and are no longer reported as the sum of starts by antibiotic agent for the reporting month.
In addition, the new tool offers the option to submit antibiotic starts manually or via a template spreadsheet.
Finally, the quarterly antibiotic start benchmarking reports display additional graphs with the new data, including antibiotic starts by antibiotic class and indication as well as average days of therapy by indication.
Why did we make these changes?
Feedback from participating facilities suggested many would like to see indication for antibiotic starts included in the benchmarking reports. Over 80 percent of participating facilities indicated they would be able to report additional data including indication and duration of therapy. The improved survey tool and benchmarking reports now allow you to make inferences about the appropriateness of prescribing patterns.
What is an antibiotic start?
An antibiotic start is a new antibiotic prescription. A new resident admitted to your facility already on an antibiotic would also count as an antibiotic start for the month that they were admitted.
How do I report antibiotic starts?
Antibiotic starts are no longer reported as the sum of starts by antibiotic agent for the reporting month. Instead, report each antibiotic start for the reporting month individually, including the antibiotic name, the indication for the prescription, duration of therapy, etc.
The new tool offers the option to submit antibiotic starts manually or via a template spreadsheet. One of the last questions on the first page of the survey tool asks, "Will you be manually entering antibiotic start data into this survey form or uploading a template spreadsheet?"
Reporting Antibiotic Starts Manually
If you would prefer to enter antibiotic starts manually, select "Enter through this survey" and click "Submit." This will take you to the next page of the survey, where you will enter information regarding each antibiotic start. This page is a repeatable form; complete the form for each antibiotic start for the reporting month. To report additional antibiotic starts for the month, click "Submit" and then "Add Another Antibiotic Start." When you are done reporting for the month, simply close out of the survey.
Reporting Antibiotic Starts Via the Template Spreadsheet
If you would prefer to enter antibiotic starts via the template spreadsheet, select "Upload spreadsheet" and download the template spreadsheet. Follow the instructions for using the template spreadsheet
Why should I report my antibiotic start data to DPH?
Antibiotic Tracking is a CDC Core Element of Antibiotic Stewardship. Quarterly antibiotic start benchmarking reports allow you to assess how your antibiotic use compares to other similar facilities in the state. These reports can be used to start an essential conversation about responsible antibiotic use with leadership at your facility.
When do I report?
You can report data for any of the three months of a quarter throughout that quarter and up to a month following the end of a quarter.
For example, you can report January data from February 1 to April 30.
You can report all three months at one time (you will still need to fill out the survey three separate times) or continue to report monthly as you have in the past.
Where do I enter my data?
Enter your monthly data using this online tool
Do I use the same link every month?
Yes.
How are antibiotic start rates calculated?
Antibiotic start rates are calculated by dividing the total number of antibiotic starts by the total number of resident days.
How do I report resident days?
Resident days are the sum of the number of days each resident spent in your facility for the reporting month. Starting in 2025, resident days will be estimated by the resident census on the last day of the reporting month multiplied by the number of days in that month. The survey tool estimates resident days automatically based on the resident census on the last day of the reporting month. You do not need to perform any calculations.
When will I receive my benchmarking report?
The Department of Public Health (DPH) generates quarterly benchmarking antibiotic start reports to participating facilities. You report monthly, but the benchmarking reports reflect aggregated data by quarter.
We send benchmarking reports to participating facilities quarterly after the end of each reporting period. For example, the quarter 1 reporting period ends April 30, so participating facilities should expect benchmarking reports in early May.
To receive a benchmarking report, you need to report at least one month of data during the quarterly reporting period.
See the reporting calendar here.
It’s past the reporting deadline for the quarter. Can I report data retrospectively?
You can report quarterly data past the deadline, but you will not receive a report for that quarter. DPH cannot generate a report for you past the deadline. The retrospective numbers will, however, be included in future reports.
Do not report data for prior calendar years.
If a new patient is admitted to my facility ON an antibiotic during the month I am reporting for, should I count this as an antibiotic start for the month?
Yes. Admitting a patient on an antibiotic represents an opportunity to re-evaluate the need for it.
What if I have NO antibiotic starts for the month I am reporting?
You should still complete the survey. One of the last questions on the first page of the survey tool asks, "Are you reporting one (1) or more antibiotic starts for the month?" Select "No" and click "Submit".
How should I report an antibiotic prescription that does not have an end date and is prescribed indefinitely, e.g. for prophylaxis or chronic suppression?
If the antibiotic order does not have an end date and is prescribed indefinitely, report the antibiotic as usual, only once for the month in which the antibiotic was initiated. Select "Yes" for the question "Is this antibiotic prescription indefinite?" in the survey tool.
How should I report an antibiotic prescription with a duration of therapy that extends across two or more months?
Report antibiotic starts that extend across two or more months as usual, only once for the month in which the antibiotic was initiated. For example: a resident is prescribed cephalexin for three months, from January through March. You should report the cephalexin as an antibiotic start once for January.
Antibiotic prophylaxis and chronic suppression are both given as options for indication. What is the difference between antibiotic prophylaxis and chronic suppression?
Antibiotic prophylaxis is defined as antibiotic used for the prevention of infectious diseases, such as recurrent urinary tract infection. Methenamine (Hiprex), commonly used for UTI prophylaxis, is not considered an antibiotic and not reportable.
Chronic suppression is defined as prolonged antibiotic therapy to suppress symptoms of infection when cure is not expected or possible, such as prosthetic joint infection with implant retention.
Should I report Hiprex (methenamine hippurate)?
No. This drug is not considered an antibiotic and is more accurately called an antiseptic or anti-infective drug.
Should I report antivirals such as Tamiflu or Paxlovid?
No.
Should I report antifungals such as Diflucan (fluconazole)?
No.
Should I report topical antibiotic such as Bacitracin, creams, eye drops and ointments?
No.
Can DPH send my antibiotic start report to multiple people at my facility?
DPH can only send the generated antibiotic start report to the email(s) you specify in the "Your Email Address" field of the survey. DPH does not maintain a listserv.
If you would like the report to go to multiple people, you can enter multiple emails in this field separated by semicolons. For example, "john.doe@facility.com; jane.doe@facility.com"
What if my facility is not listed in the drop-down menu under the "Facility Name" field in the survey?
Contact infectioncontrolMA@mass.gov if your facility is not listed in the drop-down menu.
Where can I find a spreadsheet that helps me to track my data throughout the month?
We recommend using IPRO’s Monthly Infection and Antibiotic Tracking Tool found here:
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