OBJECTIVE National hospital performance measures for C. difficile infection (CD) are available; comparing antibacterial use among performance levels can aid in identifying effective antimicrobial stewardship strategies to reduce CDI rates. DESIGN Hospital-level, cross-sectional analysis. METHODS Hospital characteristics (ie, demographics, medications, patient mix) were obtained for 77 hospitals for 2013. Hospitals were assigned 1 of 3 levels of a CDI standardized infection ratio (SIR): 'Worse than,' 'Better than,' or 'No different than' a national benchmark. Analyses compared medication use (total and broad-spectrum antibacterials) for 3 metrics: days of therapy per 1,000 patient days; length of therapy; and proportion of patients receiving a medication across SIR levels. A multivariate, ordered-probit regression identified characteristics associated with SIR categories. RESULTS Regarding total average antimicrobial use per patient, there was a significant difference detected in mean length of therapy: 'No different' hospitals having the longest (4.93 days) versus 'Worse' (4.78 days) and 'Better' (4.43 days) (P<.01). 'Better' hospitals used fewer total antibacterials (693 days of therapy per 1,000 patient days) versus 'No different' (776 days) versus 'Worse' (777 days) (P<.05). The 'Better' hospitals used broad-spectrum antibacterials for a shorter average length of therapy (4.03 days) versus 'No different' (4.51 days) versus 'Worse' (4.38 days) (P<.05). 'Better' hospitals used fewer broad-spectrum antibacterials (310 days of therapy per 1,000 patient days) versus 'No different' (364 days) versus 'Worse' (349 days) (P<.05). Multivariate analysis revealed that the proportion of elderly patients and chemotherapy days of therapy per 1,000 patient days was significantly negatively associated with the SIR. CONCLUSIONS These findings have potential implications regarding the need to fully account for hospital patient mix when carrying out inter-hospital comparisons of CDI rates. Infect Control Hosp Epidemiol 2016;1-7.
Pharmacology, Toxicology and Pharmaceutical Science
6
17%
Nursing and Health Professions
4
11%
Veterinary Science and Veterinary Medicine
1
3%
Biochemistry, Genetics and Molecular Biology
1
3%
Other
3
9%
Unknown
12
34%
Attention Score in Context
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 April 2016.
All research outputs
#11,397,797
of 34,363,559 outputs
Outputs from Infection control and hospital epidemiology (Online)
#3,428
of 6,159 outputs
Outputs of similar age
#119,188
of 338,582 outputs
Outputs of similar age from Infection control and hospital epidemiology (Online)
#163
of 289 outputs
Altmetric has tracked 34,363,559 research outputs across all sources so far. This one has received more attention than most of these and is in the 66th percentile.
So far Altmetric has tracked 6,159 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.3. This one is in the 44th percentile – i.e., 44% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 338,582 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 64% of its contemporaries.
We're also able to compare this research output to 289 others from the same source and published within six weeks on either side of this one. This one is in the 43rd percentile – i.e., 43% of its contemporaries scored the same or lower than it.
