Understanding the Components, Calculation, and Impact of Monthly and Seasonal Variation of the Standardized Antimicrobial Utilization Ratio (SAAR)
| Autor: | Sean N. Avedissian, Marc H. Scheetz, Jiajun Liu, Doaa Aljefri, Sarah H. Sutton, Caroline Cruce, Nathaniel J. Rhodes, Michael Postelnick, Teresa R. Zembower, David Martin, Gwendolyn M Pais |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Methicillin-Resistant Staphylococcus aureus
Inappropriate Prescribing 030501 epidemiology Biology Azithromycin Epidemiology and Surveillance 03 medical and health sciences Antimicrobial Stewardship 0302 clinical medicine Oseltamivir medicine Humans Pharmacology (medical) 030212 general & internal medicine Antibiotic use Sensitivity analyses Retrospective Studies Pharmacology Utilization ratio Seasonality Length of Stay Staphylococcal Infections Antimicrobial medicine.disease Anti-Bacterial Agents Infectious Diseases Seasons 0305 other medical science Demography |
| Popis: | This study sought to characterize the impact of 3 types of variation on the Standardized Antimicrobial Administration Ratio (SAAR) utilizing local National Healthcare Safety Network (NHSN) data. SAAR and antimicrobial days per 1,000 days present (AD/1000DP) were compiled monthly for Northwestern Memorial Hospital from 2014 to 2016. Antimicrobial consumption was aggregated into agent categories (via NHSN criteria). Month-to-month changes in SAAR and AD/1000DP were evaluated. Azithromycin and oseltamivir AD/1000DP from 2012 through 2017 were explored for seasonal variation. A sensitivity analysis was performed to explore the effect of seasonality and altered consumption at other hypothetical hospitals on the SAAR. Across agent categories for both the intensive care unit (n = 4) and general wards (n = 4), the average matched-month percent change in AD/1000DP was correlated with the corresponding change in SAAR (coefficient of determination of 0.99). The monthly mean ± standard deviation (SD) AD/1000DP was 235 (range, 47.2 to 661.5), and the mean ± SD SAAR was 1.09 ± 0.26 (range, 0.79 to 1.09) across the NHSN agent categories. Five seasons exhibited seasonal variation in AD/1000DP for azithromycin with a mean percent change of 26.76% (range, 22.27 to 30.69). Eight seasons exhibited seasonal variation in AD/1000DP for oseltamivir with a mean percent change of 129.1% (range, 32.01 to 352.74). The sensitivity analyses confirm that antimicrobial usage at comparator hospitals does not impact the local SAAR, and seasonal variation of antibiotics has the potential to impact SAAR. Month-to-month changes in the SAAR mirror monthly changes in an institution’s AD/1000DP. Seasonal variation is an important variable for future SAAR consideration, and the variable antibiotic use at peer hospitals is not currently captured by the SAAR methodology. |
| Databáze: | OpenAIRE |
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