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Pharmacotherapy. 2008 Jul;28(7):906-12. doi: 10.1592/phco.28.7.906.

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

Author information

1
Department of Pharmacy, School of Pharmacy, Virginia Commonwealth University, Medical College of Virginia Campus, Richmond, Virginia 23298, USA.

Abstract

STUDY OBJECTIVE:

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.

DESIGN:

Observational cross-sectional study.

SETTING:

Forty-two general medical-surgical hospitals, mostly in the Eastern United States.

DATA SOURCE:

Administrative claims data and hospital antibiograms during 2003.

MEASUREMENTS AND MAIN RESULTS:

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.

CONCLUSION:

Diversity of aggregate antibiotic use can be measured, but additional investigations are needed to determine if it is a useful strategy to contain resistance.

PMID:
18576905
DOI:
10.1592/phco.28.7.906
[Indexed for MEDLINE]

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