Diversity of antimicrobial use and resistance in 42 hospitals in the United States

Amy Pakyz; J Patrick Powell; Spencer E Harpe; Chris Johnson; Michael Edmond; Ron E Polk

doi:10.1592/phco.28.7.906

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Diversity of antimicrobial use and resistance in 42 hospitals in the United States

Journal article

Peer reviewed

Diversity of antimicrobial use and resistance in 42 hospitals in the United States

Amy Pakyz, J Patrick Powell, Spencer E Harpe, Chris Johnson, Michael Edmond and Ron E Polk

Pharmacotherapy, Vol.28(7), pp.906-912

07/2008

DOI: 10.1592/phco.28.7.906

PMID: 18576905

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Abstract

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. Observational cross-sectional study. Forty-two general medical-surgical hospitals, mostly in the Eastern United States. Administrative claims data and hospital antibiograms during 2003. 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. Diversity of aggregate antibiotic use can be measured, but additional investigations are needed to determine if it is a useful strategy to contain resistance.

United States

Imipenem - therapeutic use

Methicillin - administration & dosage

Imipenem - administration & dosage

Multivariate Analysis

Cross-Sectional Studies

Humans

Methicillin - therapeutic use

Drug Resistance, Bacterial

Fluoroquinolones - therapeutic use

Drug Utilization Review

Anti-Bacterial Agents - therapeutic use

Cephalosporins

Anti-Bacterial Agents - administration & dosage

Fluoroquinolones - administration & dosage

Details

Title: Subtitle: Diversity of antimicrobial use and resistance in 42 hospitals in the United States
Creators: Amy Pakyz - Virginia Commonwealth University Medical Center
J Patrick Powell
Spencer E Harpe
Chris Johnson
Michael Edmond
Ron E Polk
Resource Type: Journal article
Publication Details: Pharmacotherapy, Vol.28(7), pp.906-912
Publisher: Wiley-Blackwell; United States
DOI: 10.1592/phco.28.7.906
PMID: 18576905
ISSN: 0277-0008
eISSN: 1875-9114
Language: English
Date published: 07/2008
Academic Unit: Internal Medicine
Record Identifier: 9983905529002771

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