scholarly journals Variability in antibiotic use across Ontario acute care hospitals

2016 ◽  
Vol 72 (2) ◽  
pp. 554-563 ◽  
Author(s):  
Charlie Tan ◽  
Marian Vermeulen ◽  
Xuesong Wang ◽  
Rosemary Zvonar ◽  
Gary Garber ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospitals ◽  
Antibiotic Use

scholarly journals 785. Association between Prevalence of Laboratory-Identified Clostridioides difficile Infections (CDIs) and CDI Antibiotic Treatment in U.S. Acute Care Hospitals, 2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S437-S437
Author(s):  
Kerui Xu ◽  
Andrea L Benin ◽  
Hsiu Wu ◽  
Jonathan R Edwards ◽  
Qunna Li ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospitals ◽  
Antibiotic Use ◽  
Prevalence Rates ◽  
Hospital Level ◽  
First Line ◽  
Oral Vancomycin ◽  
Patient Admissions ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection

Abstract Background Clostridioides difficile infections (CDIs) are an urgent public health threat, accounting for 223,900 infections and 12,800 deaths in hospitalized patients annually. In early 2018, the Infectious Disease Society of America (IDSA) recommended oral vancomycin or fidaxomicin as the first-line antibiotics for CDIs. To track the uptake of IDSA’s recommendations, we evaluated the association between CDI prevalence and use of first-line antibiotics in hospitals reporting to the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN). Methods We matched 2018 hospital-level, NHSN data on laboratory-identified CDIs with NHSN antimicrobial use (AU) data for the same time period. Hospitals that submitted < 6 months of either data type in 2018 were excluded. The association between quarterly hospital-level CDI prevalence rates per 100 patient-admissions and use of CDI antibiotics (oral vancomycin plus fidaxomicin) per 1,000 days-present was evaluated using Pearson’s linear correlation coefficient and using Goodman and Kruskal’s gamma (G) on ordinal quartiles to assess rates of discordant pairs. Results Among the 2735 hospital-level quarters based on 714 hospitals included in the study, CDI prevalence (median: 0.46 per 100 patient-admissions) and CDI antibiotic use (median: 8.85 antibiotic-days per 1,000 days-present) demonstrated only a moderately positive correlation (r = 0.48). Among hospitals in the highest quartile for CDI prevalence, 5.1% were in the lowest quartile for antibiotic use. Among hospitals in the highest quartile for antibiotic use, 5.3% were in the lowest quartile for CDI prevalence, and 54.2% were in the highest quartile for CDI prevalence (G = 0.60; 95% CI: 0.57–0.63). Correlation of hospital-level Clostridioides difficile infection (CDI) prevalence rates and oral vancomycin and fidaxomicin use in U.S. acute care hospitals, 2018 Distribution of hospital-level Clostridioides difficile infection (CDI) prevalence rates and oral vancomycin and fidaxomicin use in ordinal quartiles (Q1–Q4) to access rates of discordant pairs Conclusion The moderate correlation and discordant rates suggest that vancomycin and fidaxomicin are less frequently used as primary antibiotics in some hospitals; whereas in others, CDI antibiotic use is occurring in the absence of positive laboratory tests for CDI. To further investigate this discordance, there is a need to assess hospitals’ prescribing and testing practices in an ongoing manner. These findings may be useful to serve as baseline for measuring progress of appropriateness of treatment and testing for CDIs. Disclosures All Authors: No reported disclosures

Assessing the impact of antibiotic stewardship program elements on antibiotic use across acute-care hospitals: an observational study

2018 ◽  
Vol 39 (8) ◽  
pp. 941-946 ◽  
Author(s):  
Bradley J. Langford ◽  
Julie Hui-Chih Wu ◽  
Kevin A. Brown ◽  
Xuesong Wang ◽  
Valerie Leung ◽  
...  
Keyword(s):  
Observational Study ◽  
Acute Care ◽  
Antimicrobial Stewardship ◽  
Acute Care Hospitals ◽  
Antibiotic Use ◽  
Audit And Feedback ◽  
Prospective Audit ◽  
Defined Daily Doses ◽  
Prospective Audit And Feedback ◽  
The Impact

AbstractObjectivesAntibiotic use varies widely between hospitals, but the influence of antimicrobial stewardship programs (ASPs) on this variability is not known. We aimed to determine the key structural and strategic aspects of ASPs associated with differences in risk-adjusted antibiotic utilization across facilities.DesignObservational study of acute-care hospitals in Ontario, CanadaMethodsA survey was sent to hospitals asking about both structural (8 elements) and strategic (32 elements) components of their ASP. Antibiotic use from hospital purchasing data was acquired for January 1 to December 31, 2014. Crude and adjusted defined daily doses per 1,000 patient days, accounting for hospital and aggregate patient characteristics, were calculated across facilities. Rate ratios (RR) of defined daily doses per 1,000 patient days were compared for hospitals with and without each antimicrobial stewardship element of interest.ResultsOf 127 eligible hospitals, 73 (57%) participated in the study. There was a 7-fold range in antibiotic use across these facilities (min, 253 defined daily doses per 1,000 patient days; max, 1,872 defined daily doses per 1,000 patient days). The presence of designated funding or resources for the ASP (RRadjusted, 0·87; 95% CI, 0·75–0·99), prospective audit and feedback (RRadjusted, 0·80; 95% CI, 0·67–0·96), and intravenous-to-oral conversion policies (RRadjusted, 0·79; 95% CI, 0·64–0·99) were associated with lower risk-adjusted antibiotic use.ConclusionsWide variability in antibiotic use across hospitals may be partially explained by both structural and strategic ASP elements. The presence of funding and resources, prospective audit and feedback, and intravenous-to-oral conversion should be considered priority elements of a robust ASP.

scholarly journals Correlation Between Tennessee Antibiotic Use Point Prevalence Survey and NHSN AUR Module in Four Acute Care Hospitals

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S511-S511
Author(s):  
Christopher Evans ◽  
Raphaelle Beard ◽  
Zina Gugkaeva ◽  
Brooke Stayer ◽  
Candice Simpson ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospitals ◽  
Antibiotic Use ◽  
Point Prevalence ◽  
Prevalence Survey ◽  
Point Prevalence Survey

scholarly journals Intensification of antibiotic use within acute care hospitals in the Netherlands

2012 ◽  
Vol 67 (9) ◽  
pp. 2283-2288 ◽  
Author(s):  
H. M. Kwint ◽  
P. D. van der Linden ◽  
M. M. B. Roukens ◽  
S. Natsch ◽  
Keyword(s):  
The Netherlands ◽  
Acute Care ◽  
Acute Care Hospitals ◽  
Antibiotic Use

Prevalence of healthcare associated infections and antibiotic use in Piedmont’s acute care hospitals

2018 ◽  
Vol 28 (suppl_4) ◽  
Author(s):  
F Quattrocolo ◽  
A D'Ambrosio ◽  
V Blanco ◽  
G Voglino ◽  
S Clemente ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospitals ◽  
Antibiotic Use ◽  
Healthcare Associated Infections ◽  
Healthcare Associated

scholarly journals Association of Hospital-Onset Clostridium difficile Infection Rates and Antibiotic Use in US Acute Care Hospitals, 2006–2012: An Ecologic Analysis

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S1-S1 ◽  
Author(s):  
Sophia Kazakova ◽  
James Baggs ◽  
Lawrence McDonald ◽  
Sarah Yi ◽  
Kelly Hatfield ◽  
...  
Keyword(s):  
Acute Care ◽  
Inpatient Treatment ◽  
Acute Care Hospitals ◽  
Antibiotic Use ◽  
Estimating Equation ◽  
The United States ◽  
Fourth Generation ◽  
Days Of Therapy ◽  
Facility Level ◽  
Hospital Characteristics

Abstract Background This study investigated the association between facility-level rates of hospital-onset CDI (HO-CDI) and inpatient antibiotic use (AU) in a large group of U.S. acute care hospitals over a 7-year period. Methods We used adult discharge and antibiotic use data from 552 acute care hospitals participating in the Truven Health MarketScan Hospital Database from January 1, 2006 to December 31, 2012 to determine facility-level CDI rates and AU. HO-CDI was defined as a discharge with a secondary ICD-9-CM diagnosis code for CDI (008.45) and inpatient treatment with metronidazole or oral vancomycin. The relationship between facility-level HO-CDI (HO-CDI per 10,000 patient-days (PD)) and AU (days of therapy (DOT) per 1,000 PD) was examined through multivariate general estimating equation models that accounted for the correlation between annual HO-CDI rates within a hospital. The models controlled for hospital characteristics and a facility-level rate of community-onset CDI (CO-CDI), defined as a discharge with a primary ICD-9-CM code for CDI and inpatient treatment. Results During 2006 to 2012, the mean HO-CDI rate was 11 per 10,000 PD (interquartile range (IQR): 5.7–14.7) and mean AU was 811 DOT/1,000 PD (IQR: 710–932). After controlling for facility-level CO-CDI and other hospital characteristics, overall AU was significantly associated with facility-level HO-CDI rate; for every 50 DOT/1,000 PD increase in AU, there was a 4.4% increase in the HO-CDI rate. Similarly, the only antibiotic classes significantly associated with HO-CDI were third- and fourth-generation cephalosporins (P < 0.0001) and carbapenems (P = 0.0011) with respective increases of 2.1% and 2.4% of HO-CDI per 10 DOT/1,000 PD increase. Fluoroquinolones and β-lactam/β-lactamase inhibitor combinations were not significantly associated with HO-CDI. Conclusion In this ecologic analysis of over 500 hospitals, overall antibiotic use was associated with increased rates of HO-CDI. In contrast to recent patient-level analyses in the United States and national observations in England, only third- and fourth-generation cephalosporins and carbapenems were associated with HO-CDI. Disclosures All authors: No reported disclosures.

scholarly journals Associations of facility-level antibiotic use and hospital-onset Clostridioides difficile infection in US acute-care hospitals, 2012–2018

2021 ◽  
pp. 1-3
Author(s):  
Sophia V. Kazakova ◽  
James Baggs ◽  
Sarah H. Yi ◽  
Sujan C. Reddy ◽  
Kelly M. Hatfield ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospitals ◽  
Antibiotic Use ◽  
Generation Cephalosporin ◽  
Fourth Generation ◽  
Third Generation ◽  
Hospital Level ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
Facility Level

Abstract Previously reported associations between hospital-level antibiotic use and hospital-onset Clostridioides difficile infection (HO-CDI) were reexamined using 2012–2018 data from a new cohort of US acute-care hospitals. This analysis revealed significant positive associations between total, third-generation, and fourth-generation cephalosporin, fluoroquinolone, carbapenem, and piperacillin-tazobactam use and HO-CDI rates, confirming previous findings.

Prevalence of healthcare associated infections and antibiotic use in Piedmont’s acute care hospitals

2018 ◽  
Vol 28 (suppl_4) ◽  
Author(s):  
F Quattrocolo ◽  
A D'Ambrosio ◽  
V Blanco ◽  
G Voglino ◽  
S Clemente ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospitals ◽  
Antibiotic Use ◽  
Healthcare Associated Infections ◽  
Healthcare Associated
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