Antibiotic Use in Small Community Hospitals

Area of Science:

• Infectious Diseases
• Healthcare Management
• Public Health

Background:

• Antibiotic misuse drives antimicrobial resistance, a significant global health threat.
• Small community hospitals (SCHs) provide a substantial portion of US healthcare but have poorly described antibiotic use patterns.
• Understanding antibiotic consumption in SCHs is crucial for developing targeted interventions.

Purpose of the Study:

• To evaluate and characterize antibiotic use patterns in small community hospitals (SCHs).
• To compare antibiotic prescribing in SCHs with large community hospitals (LCHs).
• To identify factors influencing antibiotic use in SCHs.

Main Methods:

• Utilized monthly antibiotic use data from 19 hospitals (2011-2013) within Intermountain Healthcare.
• Categorized hospital units and antibiotic spectrum coverage.
• Calculated antibiotic use rates (DOT/1000PD) and employed negative-binomial regression for analysis.

Main Results:

• Significant variation in antibiotic use rates observed across 15 SCHs (median 436 DOT/1000PD).
• Overall antibiotic use in SCHs was comparable to rates in 4 LCHs (median 509 DOT/1000PD).
• Broad-spectrum antibiotic use was similar between SCHs (26%) and LCHs (32%); unit type, case mix, and season predicted use.

Conclusions:

• Substantial variability exists in antibiotic prescribing practices within SCHs.
• Overall antibiotic consumption in SCHs mirrors that of LCHs.
• SCHs represent a critical setting for antimicrobial stewardship initiatives.