Clinical, contextual and hospital-level factors associated with escalation and de-escalation of empiric Gram-negative antibiotics among US inpatients.

ABSTRACT:

Background

Empiric Gram-negative antibiotics are frequently changed in response to new information. To inform antibiotic stewardship, we sought to identify predictors of antibiotic changes using information knowable before microbiological test results.

Methods

We performed a retrospective cohort study. Survival-time models were used to evaluate clinical factors associated with antibiotic escalation and de-escalation (defined as an increase or decrease, respectively, in the spectrum or number of Gram-negative antibiotics within 5 days of initiation). Spectrum was categorized as narrow, broad, extended or protected. Tjur's D statistic was used to estimate the discriminatory power of groups of variables.

Results

In 2019, 2 751 969 patients received empiric Gram-negative

SUBMITTER: Baghdadi JD 

PROVIDER: S-EPMC10182731 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature