Table 2.
Characteristics of Patients With and Without Antibiotic Overuse at Hospital Discharge
| Variable | Antibiotic overuse after discharge, n = 10 709 | No antibiotic overuse after discharge, n = 11 116 | P value |
|---|---|---|---|
| Race, White,a n/N (%) | 8186/10 661 (76.8%) | 8409/11 081 (75.9%) | .11 |
| Sex, female, n (%) | 5940 (55.5%) | 6994 (62.9%) | <.001 |
| Age, median (IQR) | 72 (59–82) | 74 (61–84) | <.001 |
| Charlson Comorbidity Index, median (IQR) | 3 (1–4) | 3 (1–5) | <.001 |
| Any sepsis,b n (%) | |||
| Sepsis | 6882 (64.3%) | 6812 (61.3%) | <.001 |
| Severe sepsis | 1986 (18.5%) | 2356 (21.2%) | <.001 |
| Length of stay, days, median (IQR) | 4 (4–6) | 5 (4–7) | <.001 |
| Discharged to postacute care facilityc | 1979 (18.5%) | 2840 (25.5%) | <.001 |
| Disease state | |||
| Hospitalized patients treated for urinary tract infection, n (%) | 3633 (33.9%) | 5747 (51.7%) | <.001 |
| Asymptomatic bacteriuriad | 1431 (13.4%) | 1256 (11.3%) | |
| Complicated urinary tract infection | 1580 (14.8%) | 2486 (22.4%) | |
| Other urinary tract infection | 622 (5.8%) | 2005 (18.0%) | |
| Hospitalized patients treated for community-onset pneumonia, n (%) | 7076 (66.1%) | 5369 (48.3%) | <.001 |
| Not meeting criteriae | 1015 (9.5%) | 589 (5.3%) | |
| Community-acquired pneumonia | 4553 (42.5%) | 3052 (27.5%) | |
| Healthcare–associated pneumonia | 1508 (14.1%) | 1728 (15.5%) | |
| Antibiotic treatment and documentation | |||
| Prescribed an antibiotic after discharge, n (%) | 10709 (100%) | 5094 (45.8%) | <.001 |
| Prescribed a fluoroquinolone after discharge, n (%) | 4473 (41.8%) | 934 (8.4%) | <.001 |
| Total antibiotic duration, days, median (IQR) | 9 (8–11) | 6 (4–8) | <.001 |
| Antibiotic duration after discharge, days, median (IQR) | 5 (4–7) | 0 (0–3) | <.001 |
| Antibiotic overuse after discharge, days, median (IQR) | 4 (2–6) | N/A | N/A |
| Antibiotic duration documented in discharge summary, n (%) | 3113 (29.1%) | 3311 (29.8%) | .25 |
| Hospital characteristics, self-reported | |||
| Hospital bed size, median (IQR) | 310 (186–443) | 327 (202–520) | <.001 |
| Hospital profit type, n (%) | <.001 | ||
| For-profit | 864 (8.1%) | 691 (6.2%) | |
| Nonprofit | 9845 (91.9%) | 10 425 (93.8%) | |
| Academic hospital, n (%) | 9223 (86.1%) | 10 112 (91.0%) | <.001 |
The table shows the characteristics of patients who had antibiotic overuse after discharge, compared to those who did not. P values are shown for comparisons using a 2-sided chi-squared or Wilcoxon rank-sum test, as appropriate. P < .05 is significant.
Abbreviations: IQR, interquartile range; NA, not applicable; SIRS, systemic inflammatory response syndrome.
aThere were 83 patients missing race data (0.4%).
bSepsis was defined as 2 or more SIRS criteria. Severe sepsis was defined as sepsis plus evidence of organ dysfunction.
cIncludes long-term acute care hospitals, skilled nursing facilities, inpatient rehabilitation, and subacute rehabilitation.
dPatients treated for a urinary tract infection (ie, urine culture with bacterial growth) but without symptoms attributable to a urinary tract infection were considered to have asymptomatic bacteriuria. Uncomplicated urinary tract infection consisted of women without a urinary catheter or comorbid conditions associated with complicated urinary tract infection (see Supplementary Appendix for details).
ePatients with a discharge diagnosis of pneumonia who lacked signs or symptoms of pneumonia on hospital Day 1 or 2 or who had normal imaging tests were considered not to meet the criteria for pneumonia (see Supplementary Appendix for details).