Abstract
Objectives: To determine whether adjusting the denominator of the common hospital antibiotic use measurement unit (defined daily doses/100 bed-days) by including age-adjusted comorbidity score (100 bed-days/age-adjusted comorbidity score) would result in more accurate and meaningful assessment of hospital antibiotic use. Methods: The association between the monthly sum of age-adjusted comorbidity and monthly antibiotic use was measured using time-series analysis (January 2008 to June 2012). For the purposes of conducting internal benchmarking, two antibiotic usage datasets were constructed, i.e. 2004-07 (first study period) and 2008-11 (second study period). Monthly antibiotic use was normalized per 100 bed-days and per 100 bed-days/age-adjusted comorbidity score. Results: Results showed that antibiotic use had significant positive relationships with the sum of age-adjusted comorbidity score (P = 0.0004). The results also showed that there was a negative relationship between antibiotic use and (i) alcohol-based hand rub use (P = 0.0370) and (ii) clinical pharmacist activity (P = 0.0031). Normalizing antibiotic use per 100 bed-days contributed to a comparative usage rate of 1.31, i.e. the average antibiotic use during the second period was 31% higher than during the first period. However, normalizing antibiotic use per 100 bed-days per age-adjusted comorbidity score resulted in a comparative usage rate of 0.98, i.e. the average antibiotic use was 2% lower in the second study period. Importantly, the latter comparative usage rate is independent of differences in patient density and case mix characteristics between the two studied populations. Conclusions: The proposed modified antibiotic measure provides an innovative approach to compare variations in antibiotic prescribing while taking account of patient case mix effects. © The Author 2013. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
Original language | English |
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Pages (from-to) | 1132-1141 |
Number of pages | 9 |
Journal | Journal of Antimicrobial Chemotherapy |
Volume | 69 |
Issue number | 4 |
Early online date | 11 Nov 2013 |
DOIs | |
Publication status | Published (in print/issue) - 1 Apr 2014 |
Bibliographical note
First published 11 November 2013. Had to remove this date to ensure the item became eligible for proposal for REFKeywords
- Age-adjusted comorbidity index
- Antibiotic measure
- Pharmacoepidemiology
- Time-series analysis
- aminoglycoside derivative
- amoxicillin plus clavulanic acid
- antibiotic agent
- antiinfective agent
- carbapenem derivative
- cephalosporin derivative
- chloramphenicol
- glycopeptide
- imidazole derivative
- lincosamide
- macrolide
- monobactam derivative
- nitrofuran derivative
- penicillin derivative
- quinolone derivative
- steroid
- streptomycin derivative
- sulfonamide
- tetracycline derivative
- trimethoprim derivative
- antibiotic therapy
- article
- Clostridium difficile infection
- comorbidity
- drug utilization
- hospital care
- human
- observational study
- pharmacist
- quality control
- time series analysis
- age-adjusted comorbidity index
- antibiotic measure
- pharmacoepidemiology
- time-series analysis
- Adult
- Anti-Bacterial Agents
- Benchmarking
- Drug Prescriptions
- Drug Utilization
- Health Facilities
- Humans