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Hospital antibiotic use and its relationship to age-adjusted comorbidity and alcohol-based hand rub consumption

M A Aldeyab1, J C McElnay1, M G Scott2

  • 1Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast (QUB), Belfast, Northern Ireland, UK.

Epidemiology and Infection
|May 10, 2013
PubMed

Insights

Hospital antibiotic use increases with patient comorbidity but decreases with alcohol-based hand rub use. Alcohol-based hand rub is a modifiable factor for quality improvement programs targeting antibiotic stewardship.

Area of Science:

  • Healthcare epidemiology
  • Infection control
  • Health services research

Background:

  • Hospital antibiotic usage is a critical factor in antimicrobial resistance.
  • Understanding drivers of antibiotic consumption is essential for effective stewardship.
  • Age-adjusted comorbidity and infection control practices like hand hygiene influence antibiotic prescribing.

Purpose of the Study:

  • To retrospectively evaluate the impact of age-adjusted comorbidity and alcohol-based hand rub use on monthly hospital antibiotic consumption.
  • To identify modifiable factors for quality improvement in antibiotic stewardship programs.

Main Methods:

  • Utilized a multivariate autoregressive integrated moving average (ARIMA) model.
  • Analyzed monthly data over a 5-year period (April 2005-March 2010).
  • Related total monthly antibiotic use to age-adjusted comorbidity index and alcohol-based hand rub usage.

Main Results:

  • Monthly antibiotic use showed a significant positive association with the age-adjusted comorbidity index (coefficient 1.103, P = 0.0002).
  • A significant negative association was observed between monthly antibiotic use and alcohol-based hand rub usage, with a 2-month delay (coefficient -0.069, P = 0.0533).

Conclusions:

  • Alcohol-based hand rub use is a modifiable factor that can be targeted for quality improvement initiatives to reduce hospital antibiotic use.
  • Time-series analysis is a valuable methodology for identifying predictive variables of antibiotic use in healthcare settings.
  • Further research should explore other infection control practices and their impact on antibiotic consumption.

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