Evidence map›Paper›PMID 33621326›Full record

Observational studyClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022

Antibiotic Use and Presumptive Pathogens in the Veterans Affairs Healthcare System.

Christine Tedijanto, McKenna Nevers, Matthew H Samore, Marc Lipsitch

Abstract readObservational Study
In one paragraph

Observational study in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Christine TedijantoDepartment of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA.ORCID 0000-0003-3403-5765
McKenna NeversDivision of Epidemiology, University of Utah, Salt Lake City, Utah, USA.
Matthew H SamoreDivision of Epidemiology, University of Utah, Salt Lake City, Utah, USA.
Marc LipsitchDepartment of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA.ORCID 0000-0003-1504-9213

Funding

Epidemiology of Infectious Diseases and BiodefenseT32AI007535 · NIAID · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI GRAD, YONATAN H, MURRAY, MEGAN B · 1998 to 2025
$4.8M
ACL HHS U01CK000538CDC HHS CK000538-01Department of Veterans Affairs, Veterans Health AdministrationNCEZID CDC HHS U01 CK000538NIAID NIH HHS T32 AI007535NIH HHS
6 · The paper itself

Abstract

backgroundEmpirical antibiotic use is common in the hospital. Here, we characterize patterns of antibiotic use, infectious diagnoses, and microbiological laboratory results among hospitalized patients and aim to quantify the proportion of antibiotic use that is potentially attributable to specific bacterial pathogens.

methodsWe conducted an observational study using electronic health records from acute care facilities in the US Veterans Affairs Healthcare System. From October 2017 to September 2018, 482 381 hospitalizations for 332 657 unique patients that met all criteria were included. At least 1 antibiotic was administered at 202 037 (41.9%) of included hospital stays. We measured frequency of antibiotic use, microbiological specimen collection, and bacterial isolation by diagnosis category and antibiotic group. A tiered system based on specimen collection sites and diagnoses was used to attribute antibiotic use to presumptive causative organisms.

resultsSpecimens were collected at 130 012 (64.4%) hospitalizations with any antibiotic use, and at least 1 bacterial organism was isolated at 35.1% of these stays. Frequency of bacterial isolation varied widely by diagnosis category and antibiotic group. Under increasingly lenient criteria, 10.2%-31.4% of 974 733 antibiotic days of therapy could be linked to a potential bacterial pathogen.

conclusionsOverall, the vast majority of antibiotic use could be linked to either an infectious diagnosis or microbiological specimen. Nearly one-half of antibiotic use occurred when there was a specimen collected but no bacterial organism identified, underscoring the need for rapid and improved diagnostics to optimize antibiotic use.

Indexed as

Communicable DiseasesVeteransAnti-Bacterial AgentsDelivery of Health CareHospitalsHumansAnti-Bacterial Agentsantibioticsantibiotic stewardshiphospitalizationmicrobiologyVeterans Affairs

Identifiers

PMID33621326
PMCPMC8752245

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

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.