TABLE 2.
Characteristics of Antimicrobial Utilization and Clostridium difficile Infection in Random Sample of Adult ICU Patients with Orders for Urine Cultures, Pre- and Post-Reflex Urine Culture Protocol
| Pre-intervention (n = 250) | Post-intervention (n = 250) | P value | |||
|---|---|---|---|---|---|
| Antibiotic changes in response to index urine culture, No. (%) | |||||
| Not on antibiotic, new antibiotic started | 55 (22) | 28 (11) | .002a | ||
| Not on antibiotic, no new antibiotic started | 79 (32) | 95 (38) | |||
| On antibiotic, changed based on culture result | 41 (16) | 37 (15) | .30b | ||
| On antibiotic, no change | 75 (30) | 90 (36) | |||
| Antibiotic utilization | Pre-intervention (n = 250) | Post-intervention (n = 250) | P Valuec | Post-Intervention (Reflex Urine Culture only, n = 176) | P Valued |
| Days of therapy (hospital stay), mean (SD) | 26.8 (37.3) | 26.6 (45.5) | .98 | 22.3 (29.7) | .19 |
| Days of therapy (ICU stay), mean (SD) | 18.2 (23.8) | 17.5 (21.6) | .75 | 17.8 (22.4) | .86 |
| Length of therapy (hospital stay), mean (SD) | 15.3 (17.3) | 14.9 (26.9) | .85 | 12.6 (13.8) | .09 |
| Length of therapy (ICU stay), mean (SD) | 14.4 (18.0) | 13.3 (15.4) | .50 | 13.6 (16.7) | .67 |
| C. difficile infection after index urine culture, No. (%) | 19 (8) | 14 (6) | .37 | 12 (7) | .76 |
NOTE. ICU, intensive care unit; SD, standard deviation.
P value derived from χ2 test of equal proportion between those “not on antibiotic, new antibiotic started” vs “not on antibiotic, no new antibiotic started.”
P value derived from χ2 test of equal proportion between those “on antibiotic, changed based on any culture result” vs “on antibiotic, no change.”
P value derived from unpaired t test between pre- and post-intervention groups.
P value derived from unpaired t test between pre-intervention group and those patients having an index reflex urine culture in the post-intervention period.