{"indexed":{"date-parts":[[2018,1,22]],"date-time":"2018-01-22T09:42:21Z","timestamp":1516614141429},"reference-count":39,"publisher":"Cambridge University Press (CUP)","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec id=\"S0899823X15002263_abs1\" sec-type=\"general\">\n               <jats:title>BACKGROUND<\/jats:title>\n               <jats:p>To design better antimicrobial stewardship programs, detailed data on the primary drivers and patterns of antibiotic use are needed.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec id=\"S0899823X15002263_abs2\" sec-type=\"general\">\n               <jats:title>OBJECTIVE<\/jats:title>\n               <jats:p>To characterize the indications for antibiotic therapy, agents used, duration, combinations, and microbiological justification in 6 acute-care US facilities with varied location, size, and type of antimicrobial stewardship programs.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec id=\"S0899823X15002263_abs3\" sec-type=\"general\">\n               <jats:title>DESIGN, PARTICIPANTS, AND SETTING<\/jats:title>\n               <jats:p>Retrospective medical chart review was performed on a random cross-sectional sample of 1,200 adult inpatients, hospitalized (&amp;gt;24 hrs) in 6 hospitals, and receiving at least 1 antibiotic dose on 4 index dates chosen at equal intervals through a 1-year study period (October 1, 2009\u2013September 30, 2010).<\/jats:p>\n            <\/jats:sec>\n            <jats:sec id=\"S0899823X15002263_abs4\" sec-type=\"methods\">\n               <jats:title>METHODS<\/jats:title>\n               <jats:p>Infectious disease specialists recorded patient demographic characteristics, comorbidities, microbiological and radiological testing, and agents used, dose, duration, and indication for antibiotic prescriptions.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec id=\"S0899823X15002263_abs5\" sec-type=\"results\">\n               <jats:title>RESULTS<\/jats:title>\n               <jats:p>On the index dates 4,119 (60.5%) of 6,812 inpatients were receiving antibiotics. The random sample of 1,200 case patients was receiving 2,527 antibiotics (average: 2.1 per patient); 540 (21.4%) were prophylactic and 1,987 (78.6%) were therapeutic, of which 372 (18.7%) were pathogen-directed at start. Of the 1,615 empirical starts, 382 (23.7%) were subsequently pathogen-directed and 1,231 (76.2%) remained empirical. Use was primarily for respiratory (27.6% of prescriptions) followed by gastrointestinal (13.1%) infections. Fluoroquinolones, vancomycin, and antipseudomonal penicillins together accounted for 47.1% of therapy-days.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec id=\"S0899823X15002263_abs6\" sec-type=\"conclusions\">\n               <jats:title>CONCLUSIONS<\/jats:title>\n               <jats:p>Use of broad-spectrum empirical therapy was prevalent in 6 US acute care facilities and in most instances was not subsequently pathogen directed. Fluoroquinolones, vancomycin, and antipseudomonal penicillins were the most frequently used antibiotics, particularly for respiratory indications.<\/jats:p>\n               <jats:p>\n                  <jats:italic>Infect. Control Hosp. Epidemiol.<\/jats:italic> 2015;37(1):70\u201379<\/jats:p>\n            <\/jats:sec>","DOI":"10.1017\/ice.2015.226","type":"article-journal","created":{"date-parts":[[2015,10,12]],"date-time":"2015-10-12T22:42:27Z","timestamp":1444689747000},"page":"70-79","source":"Crossref","is-referenced-by-count":7,"title":"Indications and Types of Antibiotic Agents Used in 6 Acute Care Hospitals, 2009\u20132010: A Pragmatic Retrospective Observational Study","prefix":"10.1017","volume":"37","author":[{"given":"Theodoros","family":"Kelesidis","affiliation":[]},{"given":"Nikolay","family":"Braykov","affiliation":[]},{"given":"Daniel Z.","family":"Uslan","affiliation":[]},{"given":"Daniel J.","family":"Morgan","affiliation":[]},{"given":"Sumanth","family":"Gandra","affiliation":[]},{"given":"Birgir","family":"Johannsson","affiliation":[]},{"given":"Marin L.","family":"Schweizer","affiliation":[]},{"given":"Scott A.","family":"Weisenberg","affiliation":[]},{"given":"Heather","family":"Young","affiliation":[]},{"given":"Joseph","family":"Cantey","affiliation":[]},{"given":"Eli","family":"Perencevich","affiliation":[]},{"given":"Edward","family":"Septimus","affiliation":[]},{"given":"Arjun","family":"Srinivasan","affiliation":[]},{"given":"Ramanan","family":"Laxminarayan","affiliation":[]}],"member":"56","published-online":{"date-parts":[[2015,10,12]]},"reference":[{"key":"S0899823X15002263_ref39","DOI":"10.1086\/382690","doi-asserted-by":"publisher"},{"key":"S0899823X15002263_ref40","DOI":"10.1111\/j.1475-6773.2005.00444.x","doi-asserted-by":"publisher"},{"key":"S0899823X15002263_ref9","DOI":"10.1093\/cid\/cir672","doi-asserted-by":"publisher"},{"key":"S0899823X15002263_ref37","DOI":"10.1001\/jama.2013.697","doi-asserted-by":"publisher"},{"key":"S0899823X15002263_ref8","DOI":"10.1056\/NEJMoa1306801","doi-asserted-by":"publisher"},{"key":"S0899823X15002263_ref7","DOI":"10.1086\/528810","doi-asserted-by":"publisher"},{"key":"S0899823X15002263_ref36","DOI":"10.1093\/cid\/cis464","doi-asserted-by":"publisher"},{"key":"S0899823X15002263_ref6","DOI":"10.1086\/644617","doi-asserted-by":"publisher"},{"key":"S0899823X15002263_ref35","DOI":"10.1086\/664908","doi-asserted-by":"publisher"},{"key":"S0899823X15002263_ref5","DOI":"10.1086\/670632","doi-asserted-by":"publisher"},{"key":"S0899823X15002263_ref34","DOI":"10.1002\/jhm.881","doi-asserted-by":"publisher"},{"key":"S0899823X15002263_ref4","DOI":"10.1086\/658946","doi-asserted-by":"publisher"},{"key":"S0899823X15002263_ref33","volume":"4","first-page":"CD003543","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"S0899823X15002263_ref3","DOI":"10.1186\/1471-2334-12-227","doi-asserted-by":"publisher"},{"key":"S0899823X15002263_ref32","year":"2006","volume-title":"Characteristics of adverse drug events originating during the hospital stay, 2011: statistical brief #164. 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