Sunah Song, Brigid Wilson, Taissa A Bej, Corinne Kowal, Federico Perez, David A Nace, Taylor Boyer, Katie J Suda, Charlesnika T Evans, Aoife Fleming, Robin L P Jump
{"title":"Development and validation of two novel antibiotic use metrics suitable for facilities and practitioners in post-acute and long-term care settings.","authors":"Sunah Song, Brigid Wilson, Taissa A Bej, Corinne Kowal, Federico Perez, David A Nace, Taylor Boyer, Katie J Suda, Charlesnika T Evans, Aoife Fleming, Robin L P Jump","doi":"10.1017/ice.2025.42","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Many post-acute and long-term care settings (PALTCs) struggle to measure antibiotic use via the standard metric, days of therapy (DOT) per 1000 days of care (DOC). Our objective was to develop antibiotic use metrics more tailored to PALTCs.</p><p><strong>Design: </strong>Retrospective cohort study with a validation cohort.</p><p><strong>Setting: </strong>PALTC settings within the same network.</p><p><strong>Methods: </strong>We obtained census data and pharmacy dispensing data for 13 community PALTCs (January 2020-December 2023). We calculated antibiotic DOT/1000 DOC, DOT per unique residents, and antibiotic starts per unique residents, at monthly intervals for community PALTCs. The validation cohort was 135 Veterans Affairs Community Living Centers (VA CLCs). For community PALTCs only, we determined the DOT and antibiotics starts per unique residents cared for by individual prescribers.</p><p><strong>Results: </strong>For community PALTCs, the correlation between facility-level antibiotic DOT/1000 DOC and antibiotic DOT/unique residents and antibiotic courses/unique residents was 0.97 (<i>P</i> < 0.0001) and 0.84 (<i>P</i> < 0.0001), respectively. For VA CLCs, those values were 0.96 (<i>P</i> < 0.0001) and 0.85 (<i>P</i> < 0.0001), respectively. At community PALTCs, both novel metrics permitted assessment and comparison of antibiotic prescribing among practitioners.</p><p><strong>Conclusion: </strong>At the facility level, the novel metric antibiotic DOT/unique residents demonstrated strong correlation with the standard metric. In addition to supporting tracking and reporting of antibiotic use among PALTCs, antibiotic DOT/unique residents permits visualization of the antibiotic prescribing rates among individual practitioners, and thus peer comparison, which in turn can lead to actionable feedback that helps improve antibiotic use in the care of PALTC residents.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0000,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infection Control and Hospital Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1017/ice.2025.42","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Many post-acute and long-term care settings (PALTCs) struggle to measure antibiotic use via the standard metric, days of therapy (DOT) per 1000 days of care (DOC). Our objective was to develop antibiotic use metrics more tailored to PALTCs.
Design: Retrospective cohort study with a validation cohort.
Setting: PALTC settings within the same network.
Methods: We obtained census data and pharmacy dispensing data for 13 community PALTCs (January 2020-December 2023). We calculated antibiotic DOT/1000 DOC, DOT per unique residents, and antibiotic starts per unique residents, at monthly intervals for community PALTCs. The validation cohort was 135 Veterans Affairs Community Living Centers (VA CLCs). For community PALTCs only, we determined the DOT and antibiotics starts per unique residents cared for by individual prescribers.
Results: For community PALTCs, the correlation between facility-level antibiotic DOT/1000 DOC and antibiotic DOT/unique residents and antibiotic courses/unique residents was 0.97 (P < 0.0001) and 0.84 (P < 0.0001), respectively. For VA CLCs, those values were 0.96 (P < 0.0001) and 0.85 (P < 0.0001), respectively. At community PALTCs, both novel metrics permitted assessment and comparison of antibiotic prescribing among practitioners.
Conclusion: At the facility level, the novel metric antibiotic DOT/unique residents demonstrated strong correlation with the standard metric. In addition to supporting tracking and reporting of antibiotic use among PALTCs, antibiotic DOT/unique residents permits visualization of the antibiotic prescribing rates among individual practitioners, and thus peer comparison, which in turn can lead to actionable feedback that helps improve antibiotic use in the care of PALTC residents.
期刊介绍:
Infection Control and Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. Written by infection control practitioners and epidemiologists and guided by an editorial board composed of the nation''s leaders in the field, ICHE provides a critical forum for this vital information.