TABLE 3.
Patient- and Prescription-Level Indications and Suspected Primary Infection Site for Antibiotic Use
| Course indication | Patients (N = 1,200) | Prescriptions (N = 2,527) | ||||
|---|---|---|---|---|---|---|
| N | % | N | % | DOT | % | |
| THERAPYa | 918 | (76.5) | 1,987 | (78.6) | 14,353 | 84.30 |
| PROPHYLAXISb | 395 | (32.9) | 540 | (21.4) | 2,673 | 15.70 |
| Respiratory tract | 365 | (39.8) | 697 | (27.6) | 4,660 | 32.47 |
| CAP | 200 | (21.7) | 429 | (21.6) | 2,763 | 19.25 |
| HCAP | 86 | (9.4) | 142 | (7.2) | 944 | 6.58 |
| VAP | 28 | (3.0) | 60 | (3.0) | 472 | 3.29 |
| Other RTI | 26 | (2.8) | 38 | (1.9) | 377 | 2.63 |
| COPD exacerbation | 25 | (2.7) | 28 | (1.4) | 104 | 0.72 |
| Gastrointestinal (GI) | 200 | (21.8) | 332 | (13.1) | 2,345 | 16.34 |
| GI/intra-abdominal (not C. difficile) | 136 | (14.8) | 267 | (13.4) | 1,803 | 12.56 |
| C. difficile | 64 | (7.0) | 72 | (3.6) | 542 | 3.78 |
| Bloodstreamc | 178 | (19.4) | 260 | (10.3) | 2,941 | 20.49 |
| Bacteremia/sepsis (not device-associated) | 144 | (15.7) | 290 | (14.6) | 2,195 | 15.29 |
| Central line-associated BSI | 34 | (3.7) | 50 | (2.5) | 387 | 2.70 |
| Cardiovascular infection | 17 | (1.8) | 30 | (1.5) | 359 | 2.50 |
| Urinary tract | 171 | (18.6) | 243 | (9.6) | 996 | 6.94 |
| UTI (not device-associated) | 154 | (16.8) | 233 | (11.7) | 867 | 6.04 |
| Catheter-associated UTI | 17 | (1.8) | 29 | (1.5) | 129 | 0.90 |
| Skin and soft-tissue | 171 | (18.6) | 298 | (11.8) | 1,940 | 13.52 |
| Skin/soft-tissue infection | 107 | (11.6) | 214 | (10.8) | 1,174 | 8.18 |
| Bone infection | 32 | (3.5) | 59 | (3.0) | 504 | 3.51 |
| Wound/SSI | 32 | (3.5) | 49 | (2.5) | 262 | 1.83 |
| Other | 105 | (11.4) | 158 | (6.3) | 1,471 | 10.25 |
| Other/unknown | 36 | (3.9) | 69 | (3.5) | 439 | 3.06 |
| Fever/leukocytosis | 27 | (2.9) | 42 | (2.1) | 464 | 3.23 |
| CNS infection | 20 | (2.2) | 43 | (2.2) | 396 | 2.76 |
| Other (nonbacteriological) | 15 | (1.6) | 17 | (0.9) | 162 | 1.13 |
| Unclear/not specified | 7 | (0.8) | 9 | (0.5) | 10 | 0.07 |
NOTE. Patients may have received a prescription for more than 1 indication, and prescriptions may be associated with more than 1 indication. BSI, bloodstream infection; CAP, community-associated pneumonia; C. difficile, Clostridium difficile; CNS, central nervous system; COPD, chronic obstructive pulmonary disease; DOT, days of therapy; HCAP, healthcare-associated pneumonia; PCP, Pneumocystis pneumonia; RTI, respiratory tract infection; SSI, surgical site infection; UTI, urinary tract infection; VAP, ventilator-associated pneumonia.
Percentages out of 918 patients receiving therapy and 2,527 prescriptions.
Prophylaxis included all prescription orders for the prevention of infection pre- or postoperatively, or for the management of a chronic condition, including in patients with neutropenia, cystic fibrosis, and Pneumocystis carinii pneumonia.
Bloodstream infection is defined as patients with an organism grown in blood cultures or sepsis syndrome without any organism grown in blood cultures.