Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

Health Services Research & Development

Go to the ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Broad spectrum antibiotic use at Choice, Change, and Completion throughout VA: patterns of initiation and de-escalation

Goetz MB, Graber CJ, Jones M, Madaras-Kelly K, Samore MH, Glassman PA. Broad spectrum antibiotic use at Choice, Change, and Completion throughout VA: patterns of initiation and de-escalation. [Abstract]. Open forum infectious diseases. 2017 Oct 4; 4(suppl_1):S250-S251.

Related HSR&D Project(s)




Abstract:

Background Antimicrobial stewardship programs seek to reduce initiation of unwarranted therapy, promote de-escalation and prevent excessive duration. The CDC Antibiotic Use option provides ward-level reports of antibiotic use and risk-adjusted Standardized Antibiotic Administration Ratios for pre-specified antibiotics groups that allow for inter-facility comparison, but do not provide the indication for use or temporal patterns that allow de-escalation assessments. Methods We characterized antibiotic use on days 0-2 (Choice), 3-4 (Change) and 5-6 (Completion) of therapy (CCC) for pneumonia (LRTI), skin-soft-tissue infections (SSTI) and urinary tract infection (UTI). We then explored the relationship between total MRSA or multi-drug-resistant GNR (MDRO) antibiotic use and use over CCC intervals for LRTI and SSTI for patients in acute non-ICU settings in 33 high-complexity VA facilities. Data were from 2016 and extracted from the VA Corporate Data Warehouse. Results The mean rates of anti-MRSA and anti-MDRO therapy were 108 and 123 Days of Therapy (DOT)/1000 days present, respectively. The table shows the fraction (mean, range) of patients with SSTI or LRTI receiving anti-MRSA or anti-MDRO therapy at the CCC intervals and the change in use (i.e., de-escalation) over the treatment course. Conclusion Syndrome-specific CCC metrics show substantial variations in the rates of de-escalation of antimicrobial use over treatment courses. Insights provided by these metrics will allow facilities to identify specific areas for improvement by targeting syndrome-specific initial choices of therapy or antibiotic de-escalation. Disclosures All authors: No reported disclosures.





Questions about the HSR&D website? Email the Web Team.

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.