The First International Conference on Improving Use of Medicines (ICIUM), held in Chiang Mai, Thailand, in 1997, identified the need for a set of indicators and appropriate methodology to assess the use of medicines in hospitals, particularly antimicrobials. Hospital use of antimicrobial medicines has clinical, economic, and environmental implications. Hospitals must ensure availability of these medicines while also controlling and improving prescribing practices of physicians and minimizing adverse side effects.

The manual How to Investigate Antimicrobial Medicines Use in Hospitals: Selected Indicators is a rapid assessment tool for use by hospital Drug and Therapeutics Committees, physicians, pharmacists, and managers, as well as researchers who wish to evaluate and improve antimicrobial use in hospitals. The manual can assist users in defining a limited number of indicators to objectively describe the management and use of antimicrobials in hospitals. The manual also provides guidance and step-by-step instructions for designing and carrying out an assessment of antimicrobial use and management in hospitals. The manual supports basic comparisons of antimicrobial use within a hospital over time as well as between hospitals. Once specific problems have been defined, investigators can then use guidelines in the manual to help interpret results in the context of the hospital (size, type of patient, level of complexity) and to probe more deeply to identify underlying causes and possible remedial actions.