BACKGROUND: To define appropriate antibiotic use for patients with a complicated urinary tract infection (UTI), we developed in a previous study a key set of 4 valid, guideline-based quality indicators (QIs). In the current study, we evaluated the association between appropriate antibiotic use for patients with a complicated UTI, as defined by these QIs, and length of hospital stay (LOS). METHODS: A retrospective, observational multicenter study included 1252 patients with a complicated UTI, hospitalized at internal medicine and urology departments of 19 university and nonuniversity Dutch hospitals. Data from the patients' medical charts were used to calculate QI performance scores. Multilevel mixed-model analyses were performed to relate LOS to QI performance (appropriate use or not). We controlled for the potential confounders sex, age, (urological) comorbidity, febrile UTI, and intensive care unit admission <24 hours. RESULTS: Prescribing therapy in accordance with local hospital guidelines was associated with a shorter LOS (7.3 days vs 8.7 days; P = .02), as was early intravenous-oral switching (4.8 days vs 9.1 days; P < .001). There was an inverse relationship between the proportion of appropriate use in a patient (QI sum score/number of applicable QIs) and LOS (9.3 days for lower tertile vs 7.2 days for upper tertile; overall P < .05). CONCLUSIONS: Appropriate antibiotic use in patients with a complicated UTI seems to reduce length of hospital stay and therefore favors patient outcome and healthcare costs. In particular, adherence to the total set of QIs showed a significant dose-response relationship with a shorter LOS.
BACKGROUND: To define appropriate antibiotic use for patients with a complicated urinary tract infection (UTI), we developed in a previous study a key set of 4 valid, guideline-based quality indicators (QIs). In the current study, we evaluated the association between appropriate antibiotic use for patients with a complicated UTI, as defined by these QIs, and length of hospital stay (LOS). METHODS: A retrospective, observational multicenter study included 1252 patients with a complicated UTI, hospitalized at internal medicine and urology departments of 19 university and nonuniversity Dutch hospitals. Data from the patients' medical charts were used to calculate QI performance scores. Multilevel mixed-model analyses were performed to relate LOS to QI performance (appropriate use or not). We controlled for the potential confounders sex, age, (urological) comorbidity, febrile UTI, and intensive care unit admission <24 hours. RESULTS: Prescribing therapy in accordance with local hospital guidelines was associated with a shorter LOS (7.3 days vs 8.7 days; P = .02), as was early intravenous-oral switching (4.8 days vs 9.1 days; P < .001). There was an inverse relationship between the proportion of appropriate use in a patient (QI sum score/number of applicable QIs) and LOS (9.3 days for lower tertile vs 7.2 days for upper tertile; overall P < .05). CONCLUSIONS: Appropriate antibiotic use in patients with a complicated UTI seems to reduce length of hospital stay and therefore favors patient outcome and healthcare costs. In particular, adherence to the total set of QIs showed a significant dose-response relationship with a shorter LOS.
Authors: M C Kallen; M E J L Hulscher; B Elzer; S E Geerlings; P D van der Linden; S Teerenstra; S Natsch; B C Opmeer; J M Prins Journal: J Antimicrob Chemother Date: 2021-05-12 Impact factor: 5.790
Authors: Jan-Willem H Dik; Ron Hendrix; Jerome R Lo-Ten-Foe; Kasper R Wilting; Prashant N Panday; Lisette E van Gemert-Pijnen; Annemarie M Leliveld; Job van der Palen; Alex W Friedrich; Bhanu Sinha Journal: Front Microbiol Date: 2015-06-03 Impact factor: 5.640
Authors: Daniel Drozdov; Stefanie Schwarz; Alexander Kutz; Eva Grolimund; Anna Christina Rast; Deborah Steiner; Katharina Regez; Ursula Schild; Merih Guglielmetti; Antoinette Conca; Barbara Reutlinger; Cornelia Ottiger; Florian Buchkremer; Sebastian Haubitz; Claudine Blum; Andreas Huber; Ulrich Buergi; Philipp Schuetz; Andreas Bock; Christoph Andreas Fux; Beat Mueller; Werner Christian Albrich Journal: BMC Med Date: 2015-05-01 Impact factor: 8.775
Authors: Caroline M A van den Bosch; Marlies E J L Hulscher; Stephanie Natsch; Inge C Gyssens; Jan M Prins; Suzanne E Geerlings Journal: BMC Infect Dis Date: 2014-06-20 Impact factor: 3.090
Authors: Marvin A H Berrevoets; Jaap Ten Oever; Jacobien Hoogerwerf; Bart Jan Kullberg; Femke Atsma; Marlies E Hulscher; Jeroen A Schouten Journal: JAC Antimicrob Resist Date: 2019-11-13
Authors: Annemieke K van den Broek; Berend H H Beishuizen; Eric A F Haak; Michiel Duyvendak; Jaap Ten Oever; Chris Sytsma; Mieke van Triest; Cornelia C H Wielders; Jan M Prins Journal: Antimicrob Resist Infect Control Date: 2021-07-03 Impact factor: 4.887