ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Significant Regional Differences in Antibiotic Use Across 576 US Hospitals and 11 701 326 Adult Admissions, 2016-2017.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07556107 (A Randomized Controlled Trial Comparing Renal Effects of Vancomycin Combined With Either Piperacillin/Tazobactam or Meropenem), which is not on this map. Cited by 35 papers.
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.
A Randomized Controlled Trial Comparing Renal Effects of Vancomycin Combined With Either Piperacillin/Tazobactam or Meropenem: VPT Patient Safety (VPS) Study
Who cites it
35 citing papers in PubMed, 47 citations in OpenAlex.
- Risk of acute kidney injury in patients on concomitant vancomycin and piperacillin-tazobactam compared to vancomycin and other beta-lactam agents: a large multicenter retrospective cohort study from China.Microbiology spectrum · 2026Observational
- Patient Factors Associated With Antimicrobial Utilization in the Solid Organ Transplant Population.Open forum infectious diseases · 2026Article
- Antimicrobial Use in U.S. Hospitals: Comparison of 2015 and 2023 Prevalence Surveys.Open forum infectious diseases · 2026Article
- Association Between Peer Comparison Feedback and Hospitalist Antibiotic Prescribing.JAMA network open · 2026Article
- Genome sequencing for prevention of health-care-associated bacterial infections.Nature reviews. Microbiology · 2026Review
- High prevalence of class 1 integron, biofilm formation, and antimicrobial resistance profiles of Escherichia coli isolated from cattle, water, and soil in Bangladesh.BMC microbiology · 2026Article
- Benzodiazepine prescribing patterns among Medicare providers, 2017 to 2023.Frontiers in medicine · 2026Article
- The influence of social relationships on clinician interpretation of performance data in an outpatient antibiotic stewardship intervention.Antimicrobial resistance and infection control · 2025Article
- Leveraging strain competition to address antimicrobial resistance with microbiota therapies.Gut microbes · 2025Review
- Antibiotic consumption patterns in acute care hospitals: an integrated analysis using regression modelling combining data from two surveillance systems, Germany, 2022.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- Epidemiological factors associated with the prevalence of mobile genetic elements, and antimicrobial resistance patterns in Klebsiella pneumoniae of farm environments in Bangladesh.BMC medical genomics · 2025Article
- Metrics Selection and Risk Adjustment Methods to Benchmark Inpatient Antibiotic Use.JAMA network open · 2025Article
- Association between nirmatrelvir/ritonavir treatment and antibiotic prescribing in the outpatient setting among patients with COVID-19.Microbiology spectrum · 2025Article
- New Kids on the Block: Estimating Use of Next-generation Gram-negative Antibiotics Across Greater Than 700 Hospitals in the United States.Open forum infectious diseases · 2025Article
- Carbapenem Usage in the Initial Antibiotic Therapy of Sepsis in Japanese Intensive Care Units.Cureus · 2025Article
- Correlation between carbapenem susceptibility inAntimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Prevalence of Antimicrobial Resistance Among the WHO's AWaRe Classified Antibiotics Used to Treat Urinary Tract Infections in Diabetic Women.Antibiotics (Basel, Switzerland) · 2024Article
- Impact of hypoalbuminemia on clinical outcomes among patients with obesity treated with ceftriaxone.Antimicrobial agents and chemotherapy · 2024Article
- Derivation of a risk-adjusted model to predict antibiotic prescribing among hospitalists in an academic healthcare network.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Understanding hospital antimicrobial prescribing decisions and determinants of uptake of new local antimicrobial prescribing guidelines in Laos.Wellcome open research · 2024Article
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 2 countries.
Funding
Abstract
backgroundQuantifying the amount and diversity of antibiotic use in United States hospitals assists antibiotic stewardship efforts but is hampered by limited national surveillance. Our study aimed to address this knowledge gap by examining adult antibiotic use across 576 hospitals and nearly 12 million encounters in 2016-2017.
methodsWe conducted a retrospective study of patients aged ≥ 18 years discharged from hospitals in the Premier Healthcare Database between 1 January 2016 and 31 December 2017. Using daily antibiotic charge data, we mapped antibiotics to mutually exclusive classes and to spectrum of activity categories. We evaluated relationships between facility and case-mix characteristics and antibiotic use in negative binomial regression models.
resultsThe study included 11 701 326 admissions, totaling 64 064 632 patient-days, across 576 hospitals. Overall, patients received antibiotics in 65% of hospitalizations, at a crude rate of 870 days of therapy (DOT) per 1000 patient-days. By class, use was highest among β-lactam/β-lactamase inhibitor combinations, third- and fourth-generation cephalosporins, and glycopeptides. Teaching hospitals averaged lower rates of total antibiotic use than nonteaching hospitals (834 vs 957 DOT per 1000 patient-days; P < .001). In adjusted models, teaching hospitals remained associated with lower use of third- and fourth-generation cephalosporins and antipseudomonal agents (adjusted incidence rate ratio [95% confidence interval], 0.92 [.86-.97] and 0.91 [.85-.98], respectively). Significant regional differences in total and class-specific antibiotic use also persisted in adjusted models.
conclusionsAdult inpatient antibiotic use remains high, driven predominantly by broad-spectrum agents. Better understanding reasons for interhospital usage differences, including by region and teaching status, may inform efforts to reduce inappropriate antibiotic prescribing.
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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.