Association between meeting core elements for inpatient antimicrobial stewardship and antibiotic utilization
Shaina R Bernard1, Kristi M Kuper2, Kimberly B Lee3
1Division of Surveillance and Investigation,Virginia Department of Health,Richmond,Virginia.
Abstract:
We used multivariable analyses to assess whether meeting core elements was associated with antibiotic utilization. Compliance with 7 elements versus not doing so was associated with higher use of broad-spectrum agents for community-acquired infections [days of therapy per 1,000 patient days: 155 (39) vs 133 (29), P = .02] and anti-methicillin-resistant S. aureus agents [days of therapy per 1,000 patient days: 145 (37) vs 124 (30), P = .03].
Insights
Meeting core elements guidelines was linked to increased antibiotic use for common infections and against MRSA. This suggests potential overuse of broad-spectrum and anti-MRSA agents when guidelines are followed.
Area of Science:
- Infectious Diseases
- Antimicrobial Stewardship
- Health Services Research
Background:
- Antibiotic utilization remains a critical concern in healthcare.
- Understanding factors influencing antibiotic prescribing is essential for antimicrobial stewardship.
- Compliance with evidence-based guidelines is a key target for optimizing antibiotic use.
Purpose of the Study:
- To investigate the association between adherence to core elements and antibiotic utilization patterns.
- To determine if meeting specific guideline criteria correlates with prescribing of broad-spectrum or anti-methicillin-resistant Staphylococcus aureus (MRSA) agents.
Main Methods:
- Multivariable analyses were employed to assess the relationship between guideline compliance and antibiotic use.
- Antibiotic utilization was measured in days of therapy per 1,000 patient days.
- Comparisons were made between facilities meeting 7 core elements and those not meeting them.
Main Results:
- Compliance with 7 core elements was associated with significantly higher utilization of broad-spectrum agents for community-acquired infections (155 vs. 133 days of therapy per 1,000 patient days, P = .02).
- Higher use of anti-MRSA agents was also observed in facilities meeting core elements (145 vs. 124 days of therapy per 1,000 patient days, P = .03).
Conclusions:
- Adherence to core elements for antibiotic stewardship may be associated with increased use of broad-spectrum and anti-MRSA agents.
- Further research is needed to explore the nuances of guideline implementation and its impact on antibiotic prescribing practices.
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