Table 2.
Change in Antibiotic Utilization in Patients Pre-EP vs Post-EP
| Variable | Baseline | Postintervention | Difference, P Value |
|---|---|---|---|
| Mean EP antibiotic DOT (IQR), d | |||
| UTI | 14.3 (13.7 to 15.0) | 12.9 (12.4 to 13.5) | –1.4 (–2.3 to –0.6); P = .001 |
| SSTI | 20.0 (19.2 to 20.9) | 17.9 (17.1 to 18.7) | –2.2 (–3.3 to –1.0); P < .001 |
| PNA | 18.0 (17.2 to 18.8) | 16.0 (15.3 to 16.7) | –2.0 (–3.2 to –0.9); P = .001 |
| VAP | 36.1 (31.5 to 40.8) | 26.5 (23.6 to 29.4) | –9.6 (–16.0 to –3.3); P = .003 |
| Mean EP antibiotic exposure (IQR), mg | |||
| UTI | 22 328 (21 247 to 23 408) | 18 609 (17 693 to 19 526) | –3718 (–5185 to –2252); P < .001 |
| SSTI | 41 024 (38 974 to 43 073) | 35 619 (33 778 to 37 460) | –5404 (–8227 to –2582); P < .001 |
| PNA | 33 078 (31 108 to 35 048) | 23 647 (22 283 to 25 011) | –9430 (–12 028 to –6833); P < .001 |
| VAP | 97 185 (79 041 to 115 329) | 62 938 (53 209 to 72 668) | –34 246 (–57 507 to –10 986); P = .004 |
| Mean procalcitonin antibiotic DOT (IQR), d* | |||
| UTI | 13.3 (12.9 to 13.7) | 17.4 (15.5 to 19.2) | +4.0 (2.2 to 5.9); P < .001 |
| SSTI | 18.9 (18.3 to 19.5) | 20.3 (17.7 to 22.8) | +1.4 (–1.3 to 4.0); P = .3 |
| PNA | 16.5 (15.9 to 17.0) | 18.4 (17.2 to 19.6) | +1.9 (0.5 to 3.3); P = .01 |
| VAP | 26.7 (24.0 to 29.4) | 37.5 (32.2 to 42.8) | +10.8 (4.1 to 17.5); P = .002 |
| Mean procalcitonin antibiotic exposure (IQR), mg* | |||
| UTI | 19 659 (18 967 to 20 350) | 29 915 (26 297 to 33 532) | +10 256 (6537 to 13 975); P < .001 |
| SSTI | 38 515 (37 120 to 39 910) | 35 223 (29 861 to 40 585) | –3292 (–8868 to 2285); P = .2 |
| PNA | 26 347 (25 158 to 27 537) | 33 115 (30 197 to 36 032) | +6768 (3447 to 10 088); P < .001 |
| VAP | 64 947 (55 653 to 74 242) | 99 129 (78 793 to 119 464) | +34 181 (9265 to 59 097); P = .007 |
| In-hospital mortality, No. (%) | |||
| UTI | 62 (4) | 74 (5) | OR, 1.1 (IQR, 0.7 to 1.6); P = .6 |
| SSTI | 17 (1) | 18 (1) | OR, 0.9 (IQR, 0.4 to 1.9); P = .7 |
| PNA | 131 (11) | 151 (12) | OR, 1.1 (IQR, 0.8 to 1.5); P = .4 |
| VAP | 13 (24) | 17 (23) | OR, 0.9 (IQR, 0.3 to 2.6); P = .9 |
Abbreviations: DOT, days of therapy; DRG, diagnostic-related group; EP, expected practice; IQR, interquartile range; OR, odds ratio; PNA, pneumonia; SSTI, skin and skin structure infection; UTI, urinary tract infection; VAP, ventilator-associated pneumonia.
aProcalcitonin data are not stratified as baseline vs post-EP time periods, but rather by use of procalcitonin testing (left column = no procalcitonin test sent, right column = with procalcitonin test).