Evaluating antibiotic stewardship programs in patients with bacteremia using administrative data: a cohort study

Area of Science:

• Infectious Diseases
• Health Services Research
• Clinical Pharmacy

Background:

• Empirical antibiotic treatment for bacteremia requires guideline evaluation.
• Administrative data offers a potential tool for assessing treatment guideline performance.
• Previous studies highlight the importance of appropriate empirical therapy in bacteremia outcomes.

Purpose of the Study:

• To evaluate the utility of administrative data in assessing new antibiotic guidelines for bacteremia.
• To examine the prognostic impact of appropriate empirical treatment under new guidelines.
• To compare outcomes between old (cephalosporins/fluoroquinolones) and new antibiotic regimens.

Main Methods:

• Retrospective analysis of 2,008 adult bacteremia patients (2010-2012).
• Categorization into 'old' (cephalosporins/fluoroquinolones) and 'new' antibiotic regimens.
• Extraction of mortality, readmission, and treatment appropriateness data from administrative records.
• Calculation of adjusted hazard ratios (HRs) for 30-day mortality and readmission.

Main Results:

• No difference in length of stay or appropriate empirical treatment rates between regimens.
• The new regimen group had significantly lower intensive care unit (ICU) admissions (3.8% vs. 12.0%).
• The new regimen group experienced lower 30-day mortality (16.4% vs. 23.4%) compared to the old regimen.

Conclusions:

• Administrative data is a valuable resource for evaluating the effectiveness of new antibiotic guidelines.
• New antibiotic regimens for bacteremia demonstrated improved patient outcomes, including reduced mortality.
• The findings support the use of administrative data for ongoing quality assessment in infectious disease management.