Selective Antibiotic Susceptibility Reporting and Broad-Spectrum Intravenous Antibiotic Use: a Multicenter Ecological Study.
Int J Antimicrob Agents. 2019 Jun 13;:
Authors: Smoke S, Raja K, Narayanan N, Brunetti L
Recent estimates of inpatient antibiotic use in the US report that broad-spectrum antibiotic use has increased significantly. The objective of this study was to assess the impact of a selective antibiotic susceptibility reporting intervention on broad-spectrum intravenous antibiotic use in seven hospitals of a health system. This was a retrospective pre- and post-interventional ecological study. Standardized selective antibiotic susceptibility reporting rules were developed and implemented between January 2016 and June 2017. The eight months before and after each individual hospital's implementation constituted the pre- and post-interventional study periods. The primary outcome was the rate of broad-spectrum intravenous antibiotics for hospital onset/multidrug-resistant infection (Broad MDR) use. Secondary outcome measures were the use rates of non-glycopeptide anti-MRSA agents, carbapenems, non-carbapenem anti-pseudomonal beta-lactams, 3rd generation cephalosporins, 1st/2nd generation cephalosporins, fluoroquinolones and narrow spectrum penicillins. Antibiotic use data was collected as inpatient intravenous antibiotic days of therapy per 1000 patient days (DOT/1000-PD). Interrupted time series analysis with segmented regression was used to compare outcomes. There was no significant change in use of Broad MDR agents (slope change, +0.54 DOT/1000-PD per month, 95%CI -1.78 to 2.87) or other antibiotic classes. While the implementation of selective antibiotic susceptibility reporting across seven hospitals had no impact on overall broad-spectrum intravenous antibiotic use, further study is needed to determine the long term impact of this intervention.
PMID: 31202924 [PubMed - as supplied by publisher]