Evidence map›Paper›PMID 36254043›Full record

ArticleMedicine2022

Quantifying the breadth of antibiotic exposure in sepsis and suspected infection using spectrum scores.

Joshua T Smith, Raj N Manickam, Fernando Barreda, John D Greene, Meghana Bhimarao, Jason Pogue, Makoto Jones, Laura Myers, Hallie C Prescott, Vincent X Liu

Open access · goldAbstract readMulticenter Study
In one paragraph

Article in Medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 35% of its field
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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Review
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

10 authors at 3 institutions in 2 countries.

Joshua T SmithPharmacy Quality and Medication Safety, Kaiser Permanente Northern California, Oakland, CA.ORCID 0000-0001-7933-4270
Raj N ManickamDivision of Research, Kaiser Permanente Northern California, Oakland, CA.
Fernando BarredaDivision of Research, Kaiser Permanente Northern California, Oakland, CA.
John D GreeneDivision of Research, Kaiser Permanente Northern California, Oakland, CA.
Meghana BhimaraoDivision of Research, Kaiser Permanente Northern California, Oakland, CA.
Jason PogueCollege of Pharmacy, University of Michigan, Ann Arbor, MI.
Makoto JonesDivision of Epidemiology, VA Salt Lake City Health Care System, Salt Lake City, UT.
Laura MyersDivision of Research, Kaiser Permanente Northern California, Oakland, CA.
Hallie C PrescottDepartment of Internal Medicine, University of Michigan, Ann Arbor, MI.
Vincent X LiuDivision of Research, Kaiser Permanente Northern California, Oakland, CA.
Kaiser Permanente · USUniversity of Michigan · USUniversity of Utah · US

Funding

Understanding and Informing Early Hospital Antibiotic Prescribing for Potential InfectionR01HS026725 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LIU, VINCENT, PRESCOTT, HALLIE CHRISTINE · 2019 to 2023
$2.2M
AHRQ HHS R01 HS026725
6 · The paper itself

Abstract

A retrospective cohort study. Studies to quantify the breadth of antibiotic exposure across populations remain limited. Therefore, we applied a validated method to describe the breadth of antimicrobial coverage in a multicenter cohort of patients with suspected infection and sepsis. We conducted a retrospective cohort study across 21 hospitals within an integrated healthcare delivery system of patients admitted to the hospital through the ED with suspected infection or sepsis and receiving antibiotics during hospitalization from January 1, 2012, to December 31, 2017. We quantified the breadth of antimicrobial coverage using the Spectrum Score, a numerical score from 0 to 64, in patients with suspected infection and sepsis using electronic health record data. Of 364,506 hospital admissions through the emergency department, we identified 159,004 (43.6%) with suspected infection and 205,502 (56.4%) with sepsis. Inpatient mortality was higher among those with sepsis compared to those with suspected infection (8.4% vs 1.2%; P < .001). Patients with sepsis had higher median global Spectrum Scores (43.8 [interquartile range IQR 32.0-49.5] vs 43.5 [IQR 26.8-47.2]; P < .001) and additive Spectrum Scores (114.0 [IQR 57.0-204.5] vs 87.5 [IQR 45.0-144.8]; P < .001) compared to those with suspected infection. Increased Spectrum Scores were associated with inpatient mortality, even after covariate adjustments (adjusted odds ratio per 10-point increase in Spectrum Score 1.31; 95%CI 1.29-1.33). Spectrum Scores quantify the variability in antibiotic breadth among individual patients, between suspected infection and sepsis populations, over the course of hospitalization, and across infection sources. They may play a key role in quantifying the variation in antibiotic prescribing in patients with suspected infection and sepsis.

Indexed as

Anti-Bacterial AgentsSepsisEmergency Service, HospitalHospitalizationHospital MortalityHumansRetrospective StudiesAnti-Bacterial Agents

Identifiers

PMID36254043
PMCPMC9575768
OpenAlexW4306247218

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.