Table 3.
Antibiotic Utilization in Delabeled Versus Non-delabeled Patients (Unadjusted Results and Using Propensity Score)
| Antibiotic | Delabeled (n = 355) |
Non-delabeled (n = 870) | Unadjusted Delabeled vs Non-delabeled | Propensity Score IPTW Delabeled vs Non-delabeled | ||
|---|---|---|---|---|---|---|
| No. (%) | No. (%) | OR (95% CI) | P Value | OR (95% CI) | P Value | |
| Antibiotic utilization | ||||||
| Index admission pre- vs posttesting | ||||||
| Narrow-spectrum penicillina | 49 (13.8) | 6 (0.7) | 23.06 (9.78–54.37) | < .001 | 13.90 (4.36–44.30) | < .001 |
| β-lactam/β-lactamase inhibitor | 61 (17.2) | 16 (1.8) | 11.07 (6.29–19.51) | < .001 | 5.95 (3.21–11.03) | < .001 |
| Any penicillin | 106 (29.9) | 22 (2.5) | 16.41 (10.15–26.53) | < .001 | 9.02 (5.19–15.66) | < .001 |
| Unrestricted cephalosporinb | 28 (7.9) | 168 (19.3) | 0.36 (.23–.55) | < .001 | 0.45 (.29–.69) | < .001 |
| Restricted cephalosporinc | 9 (2.5) | 85 (9.8) | 0.24 (.12–.48) | < .001 | 0.30 (.15–.62) | .001 |
| Restricted antibioticd | 24 (6.8) | 164 (18.9) | 0.31 (.20–.49) | < .001 | 0.38 (.24–.61) | < .001 |
| Fluoroquinolones | 10 (2.8) | 43 (4.9) | 0.56 (.28–1.12) | .102 | 0.52 (.25–1.09) | .083 |
| Vancomycin | 6 (1.7) | 28 (3.2) | 0.52 (.21–1.26) | .146 | 1.18 (.46–3.06) | .726 |
| Clindamycin | 4 (1.1) | 48 (5.5) | 0.20 (.07–.55) | .002 | 0.24 (.09–.70) | .009 |
| Carbapenems | 3 (0.8) | 9 (1.0) | 0.82 (.22–3.03) | .76 | 0.78 (.19–3.19) | .729 |
| Any antibiotic | 143 (40.3) | 323 (37.1) | 1.14 (.89–1.47) | .302 | 0.86 (.65–1.13) | .275 |
| Appropriatenesse | ||||||
| All inappropriate | 24 (6.8) | 94 (10.8) | 0.66 (.41–1.06) | .085 | 0.47 (.28–.79) | .004 |
| Some appropriate | 15 (4.2) | 108 (12.4) | 0.36 (.20–.63) | < .001 | 0.36 (.20–.66) | .001 |
| All appropriate | 104 (29.3) | 121 (13.9) | 2.22 (1.63–3.01) | < .001 | 1.40 (.99–1.97) | .055 |
| Antibiotic not required | 212 (59.7) | 547 (62.9) | Reference | Reference | ||
| Index admission pre vs 90 days posttesting | ||||||
| Narrow-spectrum penicillina | 67 (18.9) | 13 (1.5) | 15.34 (8.34–28.19) | < .001 | 10.89 (5.09–23.31) | < .001 |
| β-lactam/β-lactamase inhibitor | 81 (22.8) | 25 (2.9) | 9.99 (6.25–15.97) | < .001 | 6.68 (3.94–11.35) | < .001 |
| Any penicillin | 131 (36.9) | 36 (4.1) | 13.55 (9.11–20.16) | < .001 | 9.13 (5.75–14.50) | < .001 |
| Unrestricted cephalosporinb | 53 (14.9) | 226 (26.0) | 0.50 (.36–.69) | < .001 | 0.60 (.42–.84) | .003 |
| Restricted cephalosporinc | 34 (9.6) | 119 (13.7) | 0.67 (.45–1.00) | .05 | 0.75 (.48–1.15) | .188 |
| Restricted antibioticd | 48 (13.5) | 217 (24.9) | 0.47 (.33–.66) | < .001 | 0.52 (.36–.74) | < .001 |
| Fluoroquinolones | 13 (3.7) | 65 (7.5) | 0.47 (.26–.87) | .015 | 0.41 (.22–.77) | .006 |
| Vancomycin | 8 (2.3) | 48 (5.5) | 0.39 (.18–.84) | .016 | 0.63 (.28–1.41) | .26 |
| Clindamycin | 4 (1.1) | 62 (7.1) | 0.15 (.05–.41) | < .001 | 0.17 (.06–.49) | .001 |
| Carbapenems | 4 (1.1) | 18 (2.1) | 0.54 (.18–1.61) | .267 | 0.40 (.13–1.27) | .122 |
| Any antibiotic | 181 (51.0) | 399 (45.9) | 1.23 (.96–1.57) | .103 | 0.97 (.74–1.28) | .849 |
| Appropriatenesse | ||||||
| All inappropriate | 24 (6.8) | 109 (12.5) | 0.60 (.37–.96) | .033 | 0.43 (.26–.72) | .001 |
| Some appropriate | 37 (10.4) | 161 (18.5) | 0.62 (.42–.93) | .019 | 0.59 (.39–.90) | .015 |
| All appropriate | 120 (33.8) | 129 (14.8) | 2.52 (1.86–3.41) | < .001 | 1.78 (1.26–2.50) | .001 |
| Antibiotic not required | 174 (49.0) | 471 (54.1) | Reference | Reference | ||
Data are presented as no. (%) unless otherwise indicated.
Abbreviations: CI, confidence interval; IPTW, inverse probability of treatment weighting; OR, odds ratio.
aA narrow-spectrum penicillin was defined as 1 of penicillin VK, penicillin G, flucloxacillin, dicloxacillin, ampicillin, or amoxicillin.
bAn unrestricted cephalosporin included first- or second-generation cephalosporins.
cA restricted cephalosporin included third-generation or later cephalosporins.
dA 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).
eMultinomial logistic regression used for analysis; results expressed as relative risk ratio.