Table 2.
Antibiotic Utilization in the Delabeled Group (n = 355)
| Antibiotic Courses | Index Admission: Posttesting vs Pretesting | 90-d Posttesting vs Index Admission Pretesting | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Antibiotic | Index Admission Pretesting (n = 340) |
Index Admission Posttesting (n = 290) |
90 d Posttesting (n = 507) |
Unadjusted Analysis | Adjusted Analysisa | Unadjusted Analysis | Adjusted Analysisa | ||||
| OR (95% CI) |
P Value | OR (95% CI) |
P Value | OR (95% CI) |
P Value | OR (95% CI) |
P Value | ||||
| Narrow-spectrum penicillinb | 10 (2.9) | 78 (26.9) | 124 (24.5) | 12.14 (6.22–23.70) | < .001 | 12.39 (6.19–24.79) | < .001 | 10.68 (5.54–20.62) | < .001 | 10.51 (5.39–20.48) | < .001 |
| β-lactam/β-lactamase inhibitor | 16 (4.7) | 95 (32.8) | 150 (29.6) | 9.87 (5.04–19.31) | < .001 | 11.17 (5.76–21.65) | < .001 | 8.51 (4.40–16.44) | < .001 | 9.34 (4.83–18.07) | < .001 |
| Any penicillin | 26 (7.6) | 173 (59.7) | 274 (54.0) | 17.86 (10.50–30.37) | < .001 | 20.64 (12.09–35.22) | < .001 | 14.20 (8.63–23.36) | < .001 | 15.19 (9.19–25.10) | < .001 |
| Unrestricted cephalosporinc | 97 (28.5) | 32 (11.0) | 68 (13.4) | 0.31 (.20–.49) | < .001 | 0.31 (.20–.49) | < .001 | 0.39 (.27–.56) | < .001 | 0.40 (.28–.57) | < .001 |
| Restricted cephalosporind | 73 (21.5) | 10 (3.4) | 39 (7.7) | 0.13 (.07–.26) | < .001 | 0.12 (.06–.23) | < .001 | 0.30 (.21–.44) | < .001 | 0.29 (.19–.42) | < .001 |
| Restricted antibiotice | 105 (30.9) | 40 (13.8) | 81 (16.0) | 0.36 (.21–.60) | < .001 | 0.31 (.20–.50) | < .001 | 0.43 (.29–.62) | < .001 | 0.38 (.27–.54) | < .001 |
| Fluoroquinolones | 13 (3.8) | 14 (4.8) | 21 (4.1) | 1.28 (.62–2.62) | .508 | 1.20 (.61–2.36) | .594 | 1.09 (.52–2.26) | .824 | 0.94 (.47–1.87) | .86 |
| Vancomycin | 8 (2.4) | 6 (2.1) | 9 (1.8) | 0.88 (.32–2.44) | .801 | 0.75 (.26–2.16) | .598 | 0.75 (.28–1.99) | .563 | 0.62 (.25–1.58) | .318 |
| Clindamycin | 9 (2.6) | 7 (2.4) | 8 (1.6) | 0.91 (.25–3.32) | .886 | 0.80 (.23–2.82) | .73 | 0.59 (.16–2.12) | .418 | 0.53 (.14–1.95) | .337 |
| Carbapenems | 2 (0.6) | 3 (1.0) | 4 (0.8) | 1.77 (.30–10.27) | .526 | 2.17 (.44–10.79) | .345 | 1.34 (.25–7.18) | .729 | 1.42 (.31–6.64) | .652 |
| Antibiotic appropriatenessf | 229 (67.4) | 227 (78.3) | 404 (79.7) | 2.16 (1.41–3.31) | < .001 | 2.07 (1.35–3.18) | .001 | 2.19 (1.50–3.21) | < .001 | 2.13 (1.45–3.13) | < .001 |
Data are presented as no. (%) unless otherwise indicated.
Abbreviations: CI, confidence interval; OR, odds ratio.
aAdjusted for sex, age-adjusted Charlson comorbidity index, microbiological diagnosis, and sepsis.
bA narrow-spectrum penicillin was defined as 1 of penicillin VK, penicillin G, flucloxacillin, dicloxacillin, ampicillin, or amoxicillin.
cAn unrestricted cephalosporin included first- or second-generation cephalosporins.
dA restricted cephalosporin included third-generation or later cephalosporins.
eA restricted antibiotic included lincosamides (ie, clindamycin, lincomycin), fluoroquinolones (ie, norfloxacin, ciprofloxacin, moxifloxacin), vancomycin, carbapenems (ie, ertapenem, meropenem), and third-generation or later cephalosporins (ie, cefepime, ceftazidime, ceftriaxone).
fA National Antimicrobial Prescribing Survey score of 1 or 2 (appropriate).