Between-centre variation in antibiotic therapeutic drug monitoring and obtaining surveillance cultures in Dutch intensive care units (ICUs): A retrospective observational study
Authors' conclusion
Substantial variation was observed between ICUs, indicating room for quality improvement. This could not be explained by case-mix, which suggests that organizational factors are possible drivers of this variation.
Study context
- Population
- Admissions to eleven Dutch ICUs, 2019 to 2023
- Participants
- 64,858 ICU admissions
- Outcome
- Adherence to and between-ICU variation in process quality indicators (QIs) for TDM and SDD/SOD administration and surveillance (adjusted variation as median OR)
Methodological detailsmulticentre, multilevel logistic regression
- Multicentre
- Multilevel logistic regression
Main finding
As reported in the abstract
QI performance and between-ICU variation
- Median performance for timely Therapeutic Drug Monitoring (TDM)
- 73.6%
- Timely TDM, vancomycin
- 75.6%
- Timely TDM, voriconazole
- 36.8%
- Timely TDM, aminoglycosides
- 23.5%
- SDD/SOD administered
- 73.9%
- Surveillance cultures collected when SDD/SOD administered
- 92.4%
- Between-ICU variation, TDM (median odds ratio (MOR))
- 1.73
- Between-ICU variation, SDD/SOD administration (MOR)
- 2.42
- Between-ICU variation, SDD/SOD surveillance (MOR)
- 1.23
Observational data: associations, not effects.
Further findings
Antibiotic and SDD/SOD use among admissions
- Received antibiotics
- 78.8%
- Received SDD/SOD
- 35.7%
Original publication
Between-centre variation in antibiotic therapeutic drug monitoring and obtaining surveillance cultures in Dutch ICUs: A retrospective observational study. J Crit Care. Published 14 March 2026. doi:10.
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