Antimicrobial Use in US Hospitals: Comparison of Results From Emerging Infections Program Prevalence Surveys, 2015 and 2011

Author:

Magill Shelley S1,O’Leary Erin12,Ray Susan M34,Kainer Marion A5,Evans Christopher5,Bamberg Wendy M6,Johnston Helen6,Janelle Sarah J6,Oyewumi Tolulope6,Lynfield Ruth7,Rainbow Jean7,Warnke Linn7,Nadle Joelle8,Thompson Deborah L9,Sharmin Shamima9,Pierce Rebecca10,Zhang Alexia Y10,Ocampo Valerie10,Maloney Meghan11,Greissman Samantha11,Wilson Lucy E12,Dumyati Ghinwa13ORCID,Edwards Jonathan R1,Frank Linda,Godine Deborah,Martin Brittany,Parker Erin,Pasutti Lauren,Friedman Sarabeth,Jones Annika,Kosmicki Tabetha,Fisher James,Maslar Amber,Meek James,Melchreit Richard,Badrun Farzana,Fiore Anthony,Fridkin Scott K,Morabit Susan L,Perry Lewis A,Perlmutter Rebecca,Vaeth Elisabeth,Gross Annastasia,Harper Jane,Pattee Brittany,Rahmathullah Nabeelah,Baumbach Joan,Sievers Marla,Concannon Cathleen,Felsen Christina,Gellert Anita,Samper Monika,Beard Raphaelle H,Lawson Patricia,Muleta Daniel,Reed Vicky P,

Affiliation:

1. Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

2. Lantana Consulting Group, Thetford, Vermont, USA

3. Department of Medicine, Emory University, Atlanta, Georgia, USA

4. Georgia Emerging Infections Program, Decatur, Georgia, USA

5. Tennessee Department of Health, Nashville, Tennessee, USA

6. Colorado Department of Public Health and Environment, Denver, Colorado, USA

7. Minnesota Department of Health, St Paul, Minnesota, USA

8. California Emerging Infections Program, Oakland, California, USA

9. New Mexico Department of Health, Santa Fe, New Mexico, USA

10. Oregon Health Authority, Portland, Oregon, USA

11. Connecticut Emerging Infections Program, Hartford and New Haven, Connecticut, USA

12. Maryland Department of Health and University of Maryland Baltimore County, Baltimore, Maryland, USA

13. New York Emerging Infections Program and University of Rochester Medical Center, Rochester, New York, USA

Abstract

Abstract Background In the 2011 US hospital prevalence survey of healthcare-associated infections and antimicrobial use 50% of patients received antimicrobial medications on the survey date or day before. More hospitals have since established antimicrobial stewardship programs. We repeated the survey in 2015 to determine antimicrobial use prevalence and describe changes since 2011. Methods The Centers for Disease Control and Prevention’s Emerging Infections Program sites in 10 states each recruited ≤25 general and women’s and children’s hospitals. Hospitals selected a survey date from May–September 2015. Medical records for a random patient sample on the survey date were reviewed to collect data on antimicrobial medications administered on the survey date or day before. Percentages of patients on antimicrobial medications were compared; multivariable log-binomial regression modeling was used to evaluate factors associated with antimicrobial use. Results Of 12 299 patients in 199 hospitals, 6084 (49.5%; 95% CI, 48.6–50.4%) received antimicrobials. Among 148 hospitals in both surveys, overall antimicrobial use prevalence was similar in 2011 and 2015, although the percentage of neonatal critical care patients on antimicrobials was lower in 2015 (22.8% vs 32.0% [2011]; P = .006). Fluoroquinolone use was lower in 2015 (10.1% of patients vs 11.9% [2011]; P < .001). Third- or fourth-generation cephalosporin use was higher (12.2% vs 10.7% [2011]; P = .002), as was carbapenem use (3.7% vs 2.7% [2011]; P < .001). Conclusions Overall hospital antimicrobial use prevalence was not different in 2011 and 2015; however, differences observed in selected patient or antimicrobial groups may provide evidence of stewardship impact.

Funder

Centers for Disease Control and Prevention

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

Reference46 articles.

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