Hospital antibiotic use and its relationship to age-adjusted comorbidity and alcohol-based hand rub consumption

M.A. Aldeyab, J.C. McElnay, M.G. Scott, F.W.D. Elhajji, M.P. Kearney

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

The objective of this study was to evaluate the effect of age-adjusted comorbidity and alcohol-based hand rub on monthly hospital antibiotic usage, retrospectively. A multivariate autoregressive integrated moving average (ARIMA) model was built to relate the monthly use of all antibiotics grouped together with age-adjusted comorbidity and alcohol-based hand rub over a 5-year period (April 2005-March 2010). The results showed that monthly antibiotic use was positively related to the age-adjusted comorbidity index (concomitant effect, coefficient 1·103, P = 0·0002), and negatively related to the use of alcohol-based hand rub (2-month delay, coefficient-0·069, P = 0·0533). Alcohol-based hand rub is considered a modifiable factor and as such can be identified as a target for quality improvement programmes. Time-series analysis may provide a suitable methodology for identifying possible predictive variables that explain antibiotic use in healthcare settings. Future research should examine the relationship between infection control practices and antibiotic use, identify other infection control predictive factors for hospital antibiotic use, and evaluate the impact of enhancing different infection control practices on antibiotic use in a healthcare setting. © 2013 Cambridge University Press.
LanguageEnglish
Pages404-408
Number of pages5
JournalEpidemiology and Infection
Volume142
Issue number2
Early online date9 May 2013
DOIs
Publication statusPublished - Feb 2014

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Comorbidity
Hand
Alcohols
Anti-Bacterial Agents
Infection Control
Delivery of Health Care
Quality Improvement

Keywords

  • Age-adjusted co-morbidity
  • alcohol-based hand rub
  • antibiotic use
  • benchmarking
  • time-series analysis
  • alcohol
  • antibiotic agent
  • cephalosporin derivative
  • quinolone derivative
  • antiinfective agent
  • hand sanitizer
  • adult
  • age
  • age adjusted comorbidity
  • aged
  • alcohol based hand rub
  • article
  • autoregressive integrated moving average model
  • Clostridium difficile infection
  • comorbidity
  • drug use
  • health care quality
  • health program
  • hospital care
  • human
  • infection
  • infection control
  • mathematical model
  • retrospective study
  • time series analysis
  • United Kingdom
  • bacterial infection
  • cross infection
  • hand washing
  • hospital
  • middle aged
  • statistics
  • Bacterial Infections
  • statistics and numerical data
  • Adult
  • Age Factors
  • Aged
  • Anti-Bacterial Agents
  • Comorbidity
  • Cross Infection
  • Hand Hygiene
  • Hand Sanitizers
  • Hospitals
  • Humans
  • Middle Aged
  • Retrospective Studies

Cite this

Aldeyab, M.A. ; McElnay, J.C. ; Scott, M.G. ; Elhajji, F.W.D. ; Kearney, M.P. / Hospital antibiotic use and its relationship to age-adjusted comorbidity and alcohol-based hand rub consumption. In: Epidemiology and Infection. 2014 ; Vol. 142, No. 2. pp. 404-408.
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title = "Hospital antibiotic use and its relationship to age-adjusted comorbidity and alcohol-based hand rub consumption",
abstract = "The objective of this study was to evaluate the effect of age-adjusted comorbidity and alcohol-based hand rub on monthly hospital antibiotic usage, retrospectively. A multivariate autoregressive integrated moving average (ARIMA) model was built to relate the monthly use of all antibiotics grouped together with age-adjusted comorbidity and alcohol-based hand rub over a 5-year period (April 2005-March 2010). The results showed that monthly antibiotic use was positively related to the age-adjusted comorbidity index (concomitant effect, coefficient 1·103, P = 0·0002), and negatively related to the use of alcohol-based hand rub (2-month delay, coefficient-0·069, P = 0·0533). Alcohol-based hand rub is considered a modifiable factor and as such can be identified as a target for quality improvement programmes. Time-series analysis may provide a suitable methodology for identifying possible predictive variables that explain antibiotic use in healthcare settings. Future research should examine the relationship between infection control practices and antibiotic use, identify other infection control predictive factors for hospital antibiotic use, and evaluate the impact of enhancing different infection control practices on antibiotic use in a healthcare setting. {\circledC} 2013 Cambridge University Press.",
keywords = "Age-adjusted co-morbidity, alcohol-based hand rub, antibiotic use, benchmarking, time-series analysis, alcohol, antibiotic agent, cephalosporin derivative, quinolone derivative, antiinfective agent, hand sanitizer, adult, age, age adjusted comorbidity, aged, alcohol based hand rub, article, autoregressive integrated moving average model, Clostridium difficile infection, comorbidity, drug use, health care quality, health program, hospital care, human, infection, infection control, mathematical model, retrospective study, time series analysis, United Kingdom, bacterial infection, cross infection, hand washing, hospital, middle aged, statistics, Bacterial Infections, statistics and numerical data, Adult, Age Factors, Aged, Anti-Bacterial Agents, Comorbidity, Cross Infection, Hand Hygiene, Hand Sanitizers, Hospitals, Humans, Middle Aged, Retrospective Studies",
author = "M.A. Aldeyab and J.C. McElnay and M.G. Scott and F.W.D. Elhajji and M.P. Kearney",
note = "Cited By :2 Export Date: 15 September 2018 CODEN: EPINE Correspondence Address: Aldeyab, M.A.; Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast (QUB), Belfast, Northern Ireland, United Kingdom; email: maldeyab02@qub.ac.uk Chemicals/CAS: alcohol, 64-17-5; Anti-Bacterial Agents; Hand Sanitizers; Anti-Bacterial Agents; Hand Sanitizers References: Gyssens, I.C., Antibiotic policy (2011) International Journal of Antimicrobial Agents, 38 (SUPPL.), pp. 11-20; Vander Stichele, R.H., Hospital consumption of antibiotics in 15 European countries: Results of the ESAC Retrospective Data Collection (1997-2002) (2006) Journal of Antimicrobial Chemotherapy, 58, pp. 159-167; Werner, N.L., Unnecessary use of fluoroquinolone antibiotics in hospitalized patients (2011) BMC Infectious Diseases, 11, p. 187; Kuster, S.P., Correlation between case mix index and antibiotic use in hospitals (2008) Journal of Antimicrobial Chemotherapy, 62, pp. 837-842; Rogues, A.M., Use of antibiotics in hospitals in south-western France (2004) Journal of Hospital Infection, 58, pp. 187-192; Polk, R.E., Benchmarking risk-adjusted adult antibacterial drug use in 70 US academic medical center hospitals (2011) Clinical Infectious Diseases, 53, pp. 1100-1110; Charlson, M.E., A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation (1987) Journal of Chronic Diseases, 40, pp. 373-383; Aldeyab, M.A., The impact of antibiotic use on the incidence and resistance pattern of ESBL-producing bacteria in primary and secondary healthcare settings (2012) British Journal of Clinical Pharmacology, 74, pp. 171-179; Jarlier, V., Curbing methicillin-resistant Staphylo-coccus aureus in 38 French hospitals through a 15-year institutional control program (2010) Archives of Internal Medicine, 170, pp. 552-559; Aldeyab, M.A., Modelling the impact of antibiotic use and infection control practices on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus: A time-series analysis (2008) Journal of Antimicrobial Chemotherapy, 62, pp. 593-600; Kaier, K., Two time-series analyses of the impact of antibiotic consumption and alcohol-based hand disinfection on the incidences of nosocomial methicillin-resistant Staphylococcus aureus infection and Clostridium difficile infection (2009) Infection Control and Hospital Epidemiology, 30, pp. 346-353; Mahamat, A., Impact of infection control interventions and antibiotic use on hospital MRSA: A multivariate interrupted time-series analysis (2007) International Journal of Antimicrobial Agents, 30, pp. 169-176; Vernaz, N., Temporal effects of antibiotic use and hand rub consumption on the incidence of MRSA and Clostridium difficile (2008) Journal of Antimicrobial Chemotherapy, 62, pp. 601-607; Aldeyab, M.A., Quasiexperimental study of the effects of antibiotic use, gastric acid-suppressive agents, and infection control practices on the incidence of Clostridium difficile-associated diarrhea in hospitalized patients (2009) Antimicrobial Agents and Chemotherapy, 53, pp. 2082-2088; Aldeyab, M.A., Multihospital outbreak of Clos-tridium difficile ribotype 027 infection: Epidemiology and analysis of control measures (2011) Infection Control and Hospital Epidemiology, 32, pp. 210-219; Ibrahim, O.M., Polk, R.E., Benchmarking antimicrobial drug use in hospitals (2012) Expert Review of Anti-infective Therapy, 10, pp. 445-457",
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Hospital antibiotic use and its relationship to age-adjusted comorbidity and alcohol-based hand rub consumption. / Aldeyab, M.A.; McElnay, J.C.; Scott, M.G.; Elhajji, F.W.D.; Kearney, M.P.

In: Epidemiology and Infection, Vol. 142, No. 2, 02.2014, p. 404-408.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Hospital antibiotic use and its relationship to age-adjusted comorbidity and alcohol-based hand rub consumption

AU - Aldeyab, M.A.

AU - McElnay, J.C.

AU - Scott, M.G.

AU - Elhajji, F.W.D.

AU - Kearney, M.P.

N1 - Cited By :2 Export Date: 15 September 2018 CODEN: EPINE Correspondence Address: Aldeyab, M.A.; Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast (QUB), Belfast, Northern Ireland, United Kingdom; email: maldeyab02@qub.ac.uk Chemicals/CAS: alcohol, 64-17-5; Anti-Bacterial Agents; Hand Sanitizers; Anti-Bacterial Agents; Hand Sanitizers References: Gyssens, I.C., Antibiotic policy (2011) International Journal of Antimicrobial Agents, 38 (SUPPL.), pp. 11-20; Vander Stichele, R.H., Hospital consumption of antibiotics in 15 European countries: Results of the ESAC Retrospective Data Collection (1997-2002) (2006) Journal of Antimicrobial Chemotherapy, 58, pp. 159-167; Werner, N.L., Unnecessary use of fluoroquinolone antibiotics in hospitalized patients (2011) BMC Infectious Diseases, 11, p. 187; Kuster, S.P., Correlation between case mix index and antibiotic use in hospitals (2008) Journal of Antimicrobial Chemotherapy, 62, pp. 837-842; Rogues, A.M., Use of antibiotics in hospitals in south-western France (2004) Journal of Hospital Infection, 58, pp. 187-192; Polk, R.E., Benchmarking risk-adjusted adult antibacterial drug use in 70 US academic medical center hospitals (2011) Clinical Infectious Diseases, 53, pp. 1100-1110; Charlson, M.E., A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation (1987) Journal of Chronic Diseases, 40, pp. 373-383; Aldeyab, M.A., The impact of antibiotic use on the incidence and resistance pattern of ESBL-producing bacteria in primary and secondary healthcare settings (2012) British Journal of Clinical Pharmacology, 74, pp. 171-179; Jarlier, V., Curbing methicillin-resistant Staphylo-coccus aureus in 38 French hospitals through a 15-year institutional control program (2010) Archives of Internal Medicine, 170, pp. 552-559; Aldeyab, M.A., Modelling the impact of antibiotic use and infection control practices on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus: A time-series analysis (2008) Journal of Antimicrobial Chemotherapy, 62, pp. 593-600; Kaier, K., Two time-series analyses of the impact of antibiotic consumption and alcohol-based hand disinfection on the incidences of nosocomial methicillin-resistant Staphylococcus aureus infection and Clostridium difficile infection (2009) Infection Control and Hospital Epidemiology, 30, pp. 346-353; Mahamat, A., Impact of infection control interventions and antibiotic use on hospital MRSA: A multivariate interrupted time-series analysis (2007) International Journal of Antimicrobial Agents, 30, pp. 169-176; Vernaz, N., Temporal effects of antibiotic use and hand rub consumption on the incidence of MRSA and Clostridium difficile (2008) Journal of Antimicrobial Chemotherapy, 62, pp. 601-607; Aldeyab, M.A., Quasiexperimental study of the effects of antibiotic use, gastric acid-suppressive agents, and infection control practices on the incidence of Clostridium difficile-associated diarrhea in hospitalized patients (2009) Antimicrobial Agents and Chemotherapy, 53, pp. 2082-2088; Aldeyab, M.A., Multihospital outbreak of Clos-tridium difficile ribotype 027 infection: Epidemiology and analysis of control measures (2011) Infection Control and Hospital Epidemiology, 32, pp. 210-219; Ibrahim, O.M., Polk, R.E., Benchmarking antimicrobial drug use in hospitals (2012) Expert Review of Anti-infective Therapy, 10, pp. 445-457

PY - 2014/2

Y1 - 2014/2

N2 - The objective of this study was to evaluate the effect of age-adjusted comorbidity and alcohol-based hand rub on monthly hospital antibiotic usage, retrospectively. A multivariate autoregressive integrated moving average (ARIMA) model was built to relate the monthly use of all antibiotics grouped together with age-adjusted comorbidity and alcohol-based hand rub over a 5-year period (April 2005-March 2010). The results showed that monthly antibiotic use was positively related to the age-adjusted comorbidity index (concomitant effect, coefficient 1·103, P = 0·0002), and negatively related to the use of alcohol-based hand rub (2-month delay, coefficient-0·069, P = 0·0533). Alcohol-based hand rub is considered a modifiable factor and as such can be identified as a target for quality improvement programmes. Time-series analysis may provide a suitable methodology for identifying possible predictive variables that explain antibiotic use in healthcare settings. Future research should examine the relationship between infection control practices and antibiotic use, identify other infection control predictive factors for hospital antibiotic use, and evaluate the impact of enhancing different infection control practices on antibiotic use in a healthcare setting. © 2013 Cambridge University Press.

AB - The objective of this study was to evaluate the effect of age-adjusted comorbidity and alcohol-based hand rub on monthly hospital antibiotic usage, retrospectively. A multivariate autoregressive integrated moving average (ARIMA) model was built to relate the monthly use of all antibiotics grouped together with age-adjusted comorbidity and alcohol-based hand rub over a 5-year period (April 2005-March 2010). The results showed that monthly antibiotic use was positively related to the age-adjusted comorbidity index (concomitant effect, coefficient 1·103, P = 0·0002), and negatively related to the use of alcohol-based hand rub (2-month delay, coefficient-0·069, P = 0·0533). Alcohol-based hand rub is considered a modifiable factor and as such can be identified as a target for quality improvement programmes. Time-series analysis may provide a suitable methodology for identifying possible predictive variables that explain antibiotic use in healthcare settings. Future research should examine the relationship between infection control practices and antibiotic use, identify other infection control predictive factors for hospital antibiotic use, and evaluate the impact of enhancing different infection control practices on antibiotic use in a healthcare setting. © 2013 Cambridge University Press.

KW - Age-adjusted co-morbidity

KW - alcohol-based hand rub

KW - antibiotic use

KW - benchmarking

KW - time-series analysis

KW - alcohol

KW - antibiotic agent

KW - cephalosporin derivative

KW - quinolone derivative

KW - antiinfective agent

KW - hand sanitizer

KW - adult

KW - age

KW - age adjusted comorbidity

KW - aged

KW - alcohol based hand rub

KW - article

KW - autoregressive integrated moving average model

KW - Clostridium difficile infection

KW - comorbidity

KW - drug use

KW - health care quality

KW - health program

KW - hospital care

KW - human

KW - infection

KW - infection control

KW - mathematical model

KW - retrospective study

KW - time series analysis

KW - United Kingdom

KW - bacterial infection

KW - cross infection

KW - hand washing

KW - hospital

KW - middle aged

KW - statistics

KW - Bacterial Infections

KW - statistics and numerical data

KW - Adult

KW - Age Factors

KW - Aged

KW - Anti-Bacterial Agents

KW - Comorbidity

KW - Cross Infection

KW - Hand Hygiene

KW - Hand Sanitizers

KW - Hospitals

KW - Humans

KW - Middle Aged

KW - Retrospective Studies

U2 - 10.1017/S0950268813001052

DO - 10.1017/S0950268813001052

M3 - Article

VL - 142

SP - 404

EP - 408

JO - Epidemiology and Infection

T2 - Epidemiology and Infection

JF - Epidemiology and Infection

SN - 0950-2688

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ER -