Table 1.
Characteristics of Hospitals With and Without Fluoroquinolone Stewardship, Bivariable Analysis, N = 48 Hospitals
| Hospitals Without Fluoroquinolone- directed Stewardship (n = 34) | Hospitals With Fluoroquinolone- directed Stewardship (n = 14) | P Value | |
|---|---|---|---|
| Hospital characteristics, n (%) | |||
| Academica | 15 (44%) | 8 (57%) | .41 |
| Location | .23 | ||
| Metropolitan | 24 (71%) | 13 (93%) | |
| Micropolitan | 7 (21%) | 1 (7%) | |
| Rural | 3 (9%) | 0 (0%) | |
| Profit type | .07 | ||
| Non-profit | 29 (85%) | 8 (57%) | |
| For profit | 3 (9%) | 2 (14%) | |
| Governmental | 2 (6%) | 4 (29%) | |
| Bed size | .82 | ||
| Median (IQR) | 305 (186–391) | 278 (136–584) | |
| Mean (SD) | 328 (242) | 365 (264) | |
| <50 Beds | 0 (0) | 0 (0) | |
| 51–100 Beds | 4 (12%) | 2 (14%) | |
| 101–200 Beds | 6 (18%) | 4 (29%) | |
| >200 Beds | 24 (71%) | 8 (57%) | |
| Have an antimicrobial stewardship program | 33 (97%) | 13 (93%) | .51 |
| Case mix,b median (IQR) | |||
| Age | 74.3 (72.4–75.7) | 70.5 (66.7–74.8) | .03 |
| Percentage of patients who were female | 60.0 (56.5–63.3) | 60.2 (56.2–61.3) | .52 |
| Percentage of patients with sepsis on admission | 49.4 (40.2–54.1) | 53.3 (45.0–56.9) | .27 |
| Percentage of patients with Charlson Comorbidity Index ≥ 3 | 56.6 (50.4–61.5) | 57.4 (54.3–60.9) | .61 |
| Percentage of patients with Medicaid insurance | 7.1 (4.9–9.9) | 11.5 (5.5–16.6) | .03 |
| Percentage of non-white patients | 9.5 (1.4–17.4) | 15.7 (4.2–76.3) | .18 |
| Percentage of cases with documented allergy to penicillin or cephalosporin | 9.7 (7.4–12.0) | 8.4 (5.6–10.6) | .22 |
| Length of stay | 5 (4–5) | 4.5 (4–5) | .49 |
| Percentage of patients with bacteremiac | 2.7 (1.5–3.5) | 3.4 (2.4–4.6) | .08 |
| Percentage of patients with CAP | 36.7 (32.6–43.3) | 35.8 (34.0–40.2) | .71 |
| Percentage of patients with HCAP | 18.2 (15.9–22.4) | 19.9 (16.4–25.7) | .42 |
| Percentage of patients with urinary tract infection | 28.2 (21.0–32.9) | 31.7 (25.2–37.0) | .18 |
| Percentage of patients with asymptomatic bacteriuria | 13.8 (9.3–19.7) | 12.0 (8.8–13.6) | .16 |
| Percentage of patients with pyelonephritisd | 3.1 (0.7–4.4) | 4.1 (3.5–6.9) | .01 |
The data presented are from a comparison of hospital demographics (obtained by chart review) and stewardship factors (obtained by annual surveys) in hospitals with and without fluoroquinolone stewardship (pre-prescription approval or prospective audit and feedback).
Abbreviations: CAP, community-acquired pneumonia; HCAP, health-care–associated pneumonia; IQR, inter-quartile range; SD, standard deviation.
aSelf-reported.
bIncludes N = 11 748 patients at 48 hospitals.
cDoes not include blood cultures growing only organisms frequently associated with contamination.
dPyelonephritis was diagnosed by a positive urine culture plus documentation of flank pain or costovertebral angle tenderness.