Antibiotic Utilization and Opportunities for Stewardship Among Hospitalized Patients With Influenza Respiratory Tract Infection
| Autor: | David P. Nicolau, Jaber Aslanzadeh, Islam M. Ghazi, Jack W. Ross, Joseph L. Kuti, Michael D Nailor |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Male medicine.medical_specialty Epidemiology medicine.drug_class Hospitalized patients 030106 microbiology Population Antibiotics Inappropriate Prescribing 03 medical and health sciences 0302 clinical medicine Internal medicine Influenza Human medicine Humans 030212 general & internal medicine Respiratory system Hospital Costs Intensive care medicine education Respiratory Tract Infections Aged Retrospective Studies Aged 80 and over education.field_of_study Respiratory tract infections business.industry Retrospective cohort study Length of Stay Middle Aged Anti-Bacterial Agents Connecticut Infectious Diseases medicine.anatomical_structure Cohort Multivariate Analysis Linear Models Female business Respiratory tract |
| Zdroj: | Infection control and hospital epidemiology. 37(5) |
| ISSN: | 1559-6834 0899-823X |
| Popis: | OBJECTIVEHospitalized influenza patients are often treated with antibiotics empirically while awaiting final diagnosis. The goal of this study was to describe the inappropriate continuation of antibiotics for influenza respiratory tract infections (RTIs).DESIGNWe retrospectively studied adults admitted to our institution over 2 respiratory flu seasons with positive influenza RTIs. Inappropriate antibiotic duration (IAD) was defined as antibiotic use for >24 hours after a positive influenza test in patients presenting with RESULTSDuring the study period, 322 patients included in this study were admitted for influenza RTI. Respiratory cultures were ordered for 50 of these patients (15.5%) and 71 patients (22%) had a positive chest x-ray, but antibiotics were prescribed to 211 patients (65.5%) on admission. Antibiotics were inappropriately continued in 73 patients (34.5%). Patients receiving IAD had a longer length of stay (LOS) (median, 6 days; range, 4–9 days) compared with those whose antibiotics were discontinued appropriately (median, 5 days; range, 3–8 days) and those who were not treated with antibiotics (median, 4 days; range, 3–6 days;PP=.510). The 30-day readmission rates were similar as well: 9 patients (12.3%) from the IAD group were readmitted within 30 days; 21 patients (15.2%) from the group with appropriate antibiotic duration were readmitted; and 11 patients (9.9%) from the group given no antibiotics were readmitted (P=.455). Total hospital costs were greater in patients treated with IAD ($10,645; range, $6,485–$18,035) compared with the group treated with appropriate antibiotic duration ($7,479; range, $4,866–$12,922) and the group given no antibiotics $5,961 (range, $4,711–$9,575). Thus, the hospital experienced a median loss in net hospital revenue of $2,076 per IAD patient compared with a patient for which antibiotic duration was appropriate.CONCLUSIONThe majority of patients with influenza RTI received antibiotics on admission, and 34.5% were inappropriately continued on antibiotics without evidence of bacterial infection, which led to increased LOS, loss of net revenue, and no improvement in outcome. Thus, stewardship initiatives aimed at this population are warranted.Infect Control Hosp Epidemiol2016;37:583–589 |
| Databáze: | OpenAIRE |
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