Table 4.
Factors associated with non-adherence to antibiotic guideline
| Adherence (n = 778) n (%) | Non-adherence (n = 457) n (%) | Univariate analysis OR (95% CI) | p-value | Adjusted analysisaOR (95% CI) | p-value | |
|---|---|---|---|---|---|---|
| AB initiated | ||||||
| Emergency room | 670 (64.9) | 363 (35.1) | 1 | 1 | ||
| Ward | 108 (53.5) | 94 (46.5) | 1.6 (1.18, 2.18) | 0.002 | 1.7 (1.24, 2.36) | 0.001 |
| Indication for treatment | ||||||
| LRTI | 280 (68.0) | 132 (32.0) | 1 | 1 | ||
| COPD ex | 177 (63.2) | 103 (36.8) | 1.23 (0.90, 1.70) | 0.196 | 1.42 (1.03, 1.98) | 0.035 |
| Sepsis | 151 (60.9) | 97 (39.1) | 1.36 (0.98, 1.89) | 0.065 | 1.44 (1.02, 2.02) | 0.037 |
| SSTI | 90 (60.0) | 60 (40.0) | 1.41 (0.96, 2.10) | 0.079 | 1.56 (1.05, 2.31) | 0.028 |
| UTI | 80 (55.2) | 65 (44.8) | 1.72 (1.17, 2.54) | 0.006 | 1.62 (1.09, 2.41) | 0.017 |
| Hospital | ||||||
| Hospital A | 376 (60.8) | 242 (39.2) | 1 | 1 | ||
| Hospital B | 203 (70.7) | 84 (29.3) | 0.64 (0.48, 0.87) | 0.004 | 0.63 (0.46, 0.86) | 0.004 |
| Hospital C | 199 (60.3) | 131 (39.7) | 1.02 (0.78, 1.34) | 0.872 | 0.95 (0.71, 1.26) | 0.712 |
| Admitted from institution | ||||||
| No | 678 (64.3) | 377 (35.7) | 1 | |||
| Yes | 100 (55.6) | 80 (44.4) | 1.44 (1.04, 1.98) | 0.026 | 1.44 (1.04, 2.00) | 0.029 |
| Accuracy between indication for AB-treatment and discharge infection diagnosesb | ||||||
| Yes | 604 (63.3) | 350 (36.7) | 1 | 1 | ||
| No | 174 (61.9) | 107 (38.1) | 1.06 (0.81, 1.40) | 0.671 | 0.99 (0.72, 1.35) | 0.936 |
| Sex | ||||||
| Male | 411 (62.7) | 245 (37.3) | 1 | 1 | ||
| Female | 367 (63.4) | 212 (36.6) | 0.97 (0.77. 1.22) | 0.790 | 0.98 (0.77, 1.24) | 0.857 |
| Age | ||||||
| < 45 | 106 (64.6) | 58 (35.4) | 1 | 1 | ||
| 46–65 | 168 (60.7) | 109 (39.3) | 1.19 (0.79, 1.77) | 0.405 | 1.26 (0.83, 1.91) | 0.277 |
| 66–85 | 367 (62.7) | 218 (37.3) | 1.09 (0.76, 1.56) | 0.656 | 1.08 (0.73, 1.60) | 0.695 |
| > 85 | 137 (65.6) | 72 (34.4) | 0.96 (0.63, 1.47) | 0.854 | 0.87 (0.54, 1.37) | 0.540 |
| Charlson Comorbidity Index | ||||||
| CCI = 0 | 304 (65.8) | 158 (34.2) | 1 | 1 | ||
| CCI = 1 | 265 (63.1) | 155 (36.9) | 1.13 (0.85, 1.48) | 0.402 | 1.14 (0.83, 1.56) | 0.421 |
| CCI = 2 | 102 (57.9) | 74 (42.1) | 1.40 (0.98, 1.99) | 0.066 | 1.35 (0.93, 1.97) | 0.115 |
| CCI = 3 | 48 (60.8) | 31 (39.2) | 1.24 (0.76, 2.10) | 0.386 | 1.20 (0.72, 2.02) | 0.482 |
| CCI = 4 | 26 (61.9) | 16 (38.1) | 1.18 (0.62, 2.27) | 0.611 | 1.18 (0.60, 2.33) | 0.626 |
| CCI > 4 | 33 (58.9) | 23 (41.1) | 1.34 (0.76, 2.36) | 0.310 | 1.39 (0.77, 2.51) | 0.279 |
| Number of working diagnoses | ||||||
| 1 | 493 (64.6) | 270 (35.4) | 1 | 1 | ||
| 2 | 238 (60.7) | 154 (39.3) | 1.18 (0.92, 1.52) | 0.193 | 1.12 (0.87, 1.46) | 0.381 |
| 3 | 47 (58.8) | 33 (41.2) | 1.28 (0.80, 2.05) | 0.299 | 1.18 (0.73, 1.92) | 0.491 |
| Antibiotic allergiesc | ||||||
| No | 708 (63.7) | 403 (36.3) | 1 | 1 | ||
| Yes | 69 (56.6) | 53 (43.4) | 1.35 (0.92, 1.97) | 0.120 | 1.40 (0.95, 2.06) | 0.088 |
| eGFR | ||||||
| eGFR > 50 | 598 (62.6) | 357 (37.4) | 1 | 1 | ||
| eGFR < 50 | 180 (64.3) | 100 (35.7) | 0.93 (0.71, 1.23) | 0.611 | 0.88 (0.66, 1.17) | 0.378 |
a All factors are adjusted for where AB was initiated, indication for AB treatment, hospital and admittance from institution
b Measured as match between initial grouped indication for treatment and grouped discharge diagnosis
c1 data missing