ArticleInfection control and hospital epidemiology2019
Hospital-level high-risk antibiotic use in relation to hospital-associated
Article in Infection control and hospital epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Omadacycline andThe Annals of pharmacotherapy · 2023Pooled it
- Patient Factors Associated With Antimicrobial Utilization in the Solid Organ Transplant Population.Open forum infectious diseases · 2026Article
- Laboratory-DetectedHealth science reports · 2026Article
- Clostridioides difficile as a Zoonotic and Foodborne Pathogen: Reviewing the Global Evidence and South African Data.MicrobiologyOpen · 2026Review
- Long-Term Antibiotic-Driven Gut Microbiota Disruption Promotes ToxigenicInfection and drug resistance · 2026Article
- Antibiotic Usage and Healthcare-AssociatedAntibiotics (Basel, Switzerland) · 2025Article
- Describing the monthly variability of hospital-onsetInfection control and hospital epidemiology · 2024Article
- Development of a Prediction Model to Identify the Risk ofPharmacy (Basel, Switzerland) · 2024Article
- Epidemiology ofSaudi medical journal · 2024Article
- Treated, hospital-onsetInfection control and hospital epidemiology · 2024Article
- Microbiota-Based Live Biotherapeutic Products forInfection and drug resistance · 2024Review
- Make It LessGenes · 2022Review
- Hospital-onset bacteremia and fungemia: An evaluation of predictors and feasibility of benchmarking comparing two risk-adjusted models among 267 hospitals.Infection control and hospital epidemiology · 2022Article
- Gut microbiota and microbiota-based therapies forFrontiers in medicine · 2022Review
- Significant Regional Differences in Antibiotic Use Across 576 US Hospitals and 11 701 326 Adult Admissions, 2016-2017.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- A Multicenter Evaluation of the US Prevalence and Regional Variation in Macrolide-ResistantOpen forum infectious diseases · 2021Article
- Effect of Inadequate Empiric Antibacterial Therapy on Hospital Outcomes in SARS-CoV-2-Positive and -Negative US Patients With a Positive Bacterial Culture: A Multicenter Evaluation From March to November 2020.Open forum infectious diseases · 2021Article
- A multicenter analysis of the clinical microbiology and antimicrobial usage in hospitalized patients in the US with or without COVID-19.BMC infectious diseases · 2021Article
- Reductions in inpatient fluoroquinolone use and postdischargeAntimicrobial stewardship & healthcare epidemiology : ASHE · 2021Article
- Long-Term Carbapenems Antimicrobial Stewardship Program.Antibiotics (Basel, Switzerland) · 2020Article
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8 authors.
Funding
Abstract
objectiveAntibiotics are widely used by all specialties in the hospital setting. We evaluated previously defined high-risk antibiotic use in relation to Clostridioides difficile infections (CDIs).
methodsWe analyzed 2016-2017 data from 171 hospitals. High-risk antibiotics included second-, third-, and fourth-generation cephalosporins, fluoroquinolones, carbapenems, and lincosamides. A CDI case was a positive stool C. difficile toxin or molecular assay result from a patient without a positive result in the previous 8 weeks. Hospital-associated (HA) CDI cases included specimens collected >3 calendar days after admission or ≤3 calendar days from a patient with a prior same-hospital discharge within 28 days. We used the multivariable Poisson regression model to estimate the relative risk (RR) of high-risk antibiotic use on HA CDI, controlling for confounders.
resultsThe median days of therapy for high-risk antibiotic use was 241.2 (interquartile range [IQR], 192.6-295.2) per 1,000 days present; the overall HA CDI rate was 33 (IQR, 24-43) per 10,000 admissions. The overall correlation of high-risk antibiotic use and HA CDI was 0.22 (P = .003), and higher correlation was observed in teaching hospitals (0.38; P = .002). For every 100-day (per 1,000 days present) increase in high-risk antibiotic therapy, there was a 12% increase in HA CDI (RR, 1.12; 95% CI, 1.04-1.21; P = .002) after adjusting for confounders.
conclusionsHigh-risk antibiotic use is an independent predictor of HA CDI. This assessment of poststewardship implementation in the United States highlights the importance of tracking trends of antimicrobial use over time as it relates to CDI.
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