STUDY OBJECTIVE: To measure diversity (or heterogeneity) of antibiotic use in a sample of hospitals in the United States and to assess an association with bacterial resistance. DESIGN: Observational cross-sectional study. SETTING: Forty-two general medical-surgical hospitals, mostly in the Eastern United States. DATA SOURCE: Administrative claims data and hospital antibiograms during 2003. MEASUREMENTS AND MAIN RESULTS: Antibiotic use was measured by defined daily dose (DDD), and diversity was assessed by using Simpson's Index and the Shannon-Weiner Index. Aggregated antibiograms (from 17 hospitals) were used to assess resistance. There were a total of 3,655,579 patient-days during 2003, with a mean +/- SD of 87,037 +/- 62,679 patient-days/hospital. Mean +/- SD antibiotic use was 704 +/- 244 DDD/1000 patient-days/hospital, and fluoroquinolones represented the largest single class. Mean +/- SD diversity by Simpson's Index was 0.861 +/- 0.022/hospital, and a strong correlation was noted between the two diversity measures. Multivariate analysis found no significant relationship between diversity and the proportion of resistant pathogens. CONCLUSION: Diversity of aggregate antibiotic use can be measured, but additional investigations are needed to determine if it is a useful strategy to contain resistance.
STUDY OBJECTIVE: To measure diversity (or heterogeneity) of antibiotic use in a sample of hospitals in the United States and to assess an association with bacterial resistance. DESIGN: Observational cross-sectional study. SETTING: Forty-two general medical-surgical hospitals, mostly in the Eastern United States. DATA SOURCE: Administrative claims data and hospital antibiograms during 2003. MEASUREMENTS AND MAIN RESULTS: Antibiotic use was measured by defined daily dose (DDD), and diversity was assessed by using Simpson's Index and the Shannon-Weiner Index. Aggregated antibiograms (from 17 hospitals) were used to assess resistance. There were a total of 3,655,579 patient-days during 2003, with a mean +/- SD of 87,037 +/- 62,679 patient-days/hospital. Mean +/- SD antibiotic use was 704 +/- 244 DDD/1000 patient-days/hospital, and fluoroquinolones represented the largest single class. Mean +/- SD diversity by Simpson's Index was 0.861 +/- 0.022/hospital, and a strong correlation was noted between the two diversity measures. Multivariate analysis found no significant relationship between diversity and the proportion of resistant pathogens. CONCLUSION: Diversity of aggregate antibiotic use can be measured, but additional investigations are needed to determine if it is a useful strategy to contain resistance.
Authors: Jeffrey S Gerber; Jason G Newland; Susan E Coffin; Matt Hall; Cary Thurm; Priya A Prasad; Chris Feudtner; Theoklis E Zaoutis Journal: Pediatrics Date: 2010-11-15 Impact factor: 7.124
Authors: Sara C Keller; Pranita D Tamma; Sara E Cosgrove; Melissa A Miller; Heather Sateia; Julie Szymczak; Ayse P Gurses; Jeffrey A Linder Journal: J Am Board Fam Med Date: 2018 May-Jun Impact factor: 2.657