ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2015
Trends in Antibiotic Use and Nosocomial Pathogens in Hospitalized Veterans With Pneumonia at 128 Medical Centers, 2006-2010.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05975671 (Reducing Empiric VAncomycin Use in Pediatric Suspected Sepsis), which is not on this map. Cited by 35 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Reducing Empiric VAncomycin Use in Pediatric Suspected Sepsis (REVAMP-Sepsis)
Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 87 citations in OpenAlex.
- Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America.American journal of respiratory and critical care medicine · 2019Guideline
- Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016Guideline
- Rapid Detection of Methicillin-Resistant Staphylococcus aureus in BAL: A Pilot Randomized Controlled Trial.Chest · 2019Trial
- Pharmacokinetic-pharmacodynamic target attainment with continuous infusion piperacillin in patients admitted to the ICU with hospital-acquired pneumonia.Antimicrobial agents and chemotherapy · 2026Article
- Investigating risk factors for methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa in community acquired pneumonia: a model for using only electronic data capture.Pneumonia (Nathan Qld.) · 2025Article
- Comparing the mortality of patients with sepsis using empirical piperacillin/tazobactam and cefepime: analysis of the MIMIC-IV database.The Journal of antimicrobial chemotherapy · 2025Article
- Cavitary Pneumonia Causes in the Arid Landscapes of Southern Arizona.American journal of medicine open · 2025Article
- Assessing the Predictive Value of Methicillin-ResistantOpen forum infectious diseases · 2024Article
- Guideline-Concordant Therapy for Community-Acquired Pneumonia in the Hospitalized Population: A Systematic Review and Meta-analysis.Open forum infectious diseases · 2024Article
- Article
- ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia.Intensive care medicine · 2023Article
- Identify Drug-Resistant Pathogens in Patients with Community-Acquired Pneumonia.Advances in respiratory medicine · 2023Review
- Impact of Order-Set Modifications and Provider Education Following Guideline Updates on Broad-Spectrum Antibiotic Use in Patients Admitted With Community Acquired Pneumonia.Hospital pharmacy · 2022Article
- Host gut resistome in Gulf War chronic multisymptom illness correlates with persistent inflammation.Communications biology · 2022Article
- Improving Vancomycin Stewardship in Critically Ill Children.Pediatrics · 2022Article
- Empiric Treatment in HAP/VAP: "Don't You Want to Take a Leap of Faith?"Antibiotics (Basel, Switzerland) · 2022Review
- Antibiotic Use and Presumptive Pathogens in the Veterans Affairs Healthcare System.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Observational
- Effectiveness of an electronic health system-based best-practice advisory to enhance the time to de-escalation of vancomycin for respiratory indications.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Article
- Effect of rapid methicillin-resistant Staphylococcus aureus nasal polymerase chain reaction screening on vancomycin use in the intensive care unit.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2021Article
- Initial antimicrobial management of sepsis.Critical care (London, England) · 2021Review
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 2 countries.
Funding
Abstract
backgroundIn 2005, pneumonia practice guidelines recommended broad-spectrum antibiotics for patients with risk factors for nosocomial pathogens. The impact of these recommendations on the ability of providers to match treatment with nosocomial pathogens is unknown.
methodsAmong hospitalizations with a principal diagnosis of pneumonia at 128 Department of Veterans Affairs medical centers from 2006 through 2010, we measured annual trends in antibiotic selection; initial blood or respiratory cultures positive for methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, and Acinetobacter species; and alignment between antibiotic coverage and culture results for MRSA and P. aeruginosa, calculating sensitivity, specificity, and diagnostic odds ratio using a 2 × 2 contingency table.
resultsIn 95 511 hospitalizations for pneumonia, initial use of vancomycin increased from 16% in 2006 to 31% in 2010, and piperacillin-tazobactam increased from 16% to 27%, and there was a decrease in both ceftriaxone (from 39% to 33%) and azithromycin (change from 39% to 36%) (P < .001 for all). The proportion of hospitalizations with cultures positive for MRSA decreased (from 2.5% to 2.0%; P < .001); no change was seen for P. aeruginosa (1.9% to 2.0%; P = .14) or Acinetobacter spp. (0.2% to 0.2%; P = .17). For both MRSA and P. aeruginosa, sensitivity increased (from 46% to 65% and 54% to 63%, respectively; P < .001) and specificity decreased (from 85% to 69% and 76% to 68%; P < .001), with no significant changes in diagnostic odds ratio (decreases from 4.6 to 4.1 [P = .57] and 3.7 to 3.2 [P = .95], respectively).
conclusionsBetween 2006 and 2010, we found a substantial increase in the use of broad-spectrum antibiotics for pneumonia despite no increase in nosocomial pathogens. The ability of providers to accurately match antibiotic coverage to nosocomial pathogens remains low.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.