National Healthcare Quality and Disparities Report
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Search All Research Studies
AHRQ Research Studies Date
Topics
- (-) Antibiotics (17)
- Antimicrobial Stewardship (9)
- Care Management (1)
- Case Study (1)
- Children/Adolescents (3)
- Clostridium difficile Infections (1)
- Community-Acquired Infections (2)
- Comparative Effectiveness (1)
- Critical Care (1)
- Digestive Disease and Health (1)
- Elderly (3)
- Evidence-Based Practice (2)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (5)
- Healthcare Costs (1)
- Healthcare Utilization (1)
- Hospitalization (1)
- Hospitals (1)
- Imaging (2)
- Infectious Diseases (4)
- Long-Term Care (2)
- (-) Medication (17)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (2)
- Newborns/Infants (1)
- Nursing Homes (2)
- Outcomes (1)
- Patient Safety (3)
- Pneumonia (2)
- Practice Patterns (1)
- Prevention (3)
- Shared Decision Making (1)
- Sickle Cell Disease (1)
- Surgery (1)
- Urinary Tract Infection (UTI) (2)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 17 of 17 Research Studies DisplayedAnesi JA, Lautenbach E, Nachamkin I
Poor clinical outcomes associated with community-onset urinary tract infections due to extended-spectrum cephalosporin-resistant Enterobacteriaceae.
In this retrospective cohort study, the investigators sought to determine the clinical outcomes associated with community-onset ESC-resistant (ESC-R) EB urinary tract infections (UTIs) in a US health system. The authors found that community-onset UTI due to an ESC-R EB organism was significantly associated with clinical failure, which may be due in part to inappropriate initial antibiotic therapy. They indicate that further studies are needed to determine which patients in the community are at high risk for drug-resistant infection to help inform prompt diagnosis and appropriate antibiotic prescribing for ESC-R EB.
AHRQ-funded; HS020002.
Citation: Anesi JA, Lautenbach E, Nachamkin I .
Poor clinical outcomes associated with community-onset urinary tract infections due to extended-spectrum cephalosporin-resistant Enterobacteriaceae.
Infect Control Hosp Epidemiol 2018 Dec;39(12):1431-35. doi: 10.1017/ice.2018.254..
Keywords: Antibiotics, Community-Acquired Infections, Medication, Outcomes, Patient Safety, Urinary Tract Infection (UTI)
Frush JM, Zhu Y, Edwards KM
Prevalence of staphylococcus aureus and use of antistaphylococcal therapy in children hospitalized with pneumonia.
In a studied group of children hospitalized with community-acquired pneumonia, staphylococcal pneumonia was rare but associated with adverse in-hospital outcomes. Despite this low prevalence, use of antistaphylococcal antibiotics was common. The authors recommended efforts to minimize overuse of antistaphylococcal antibiotics while also ensuring adequate treatment for pathogen-specific diseases.
AHRQ-funded; HS022342.
Citation: Frush JM, Zhu Y, Edwards KM .
Prevalence of staphylococcus aureus and use of antistaphylococcal therapy in children hospitalized with pneumonia.
J Hosp Med 2018 Dec;13(12):848-52. doi: 10.12788/jhm.3093..
Keywords: Children/Adolescents, Infectious Diseases, Pneumonia, Methicillin-Resistant Staphylococcus aureus (MRSA), Community-Acquired Infections, Hospitalization, Antibiotics, Medication
Varda BK, Finkelstein JB, Wang HH
The association between continuous antibiotic prophylaxis and UTI from birth until initial postnatal imaging evaluation among newborns with antenatal hydronephrosis.
This study examined whether the routine use of continuous antibiotic prophylaxis (CAP) before initial postnatal imaging is effective to prevent urinary tract infection (UTI) in infants with a history of antenatal urinary tract dilation (AUTD). A single-institution, retrospective cohort study of infants with a history of AUTD was conducted. A random sample of 500 infants was selected with six excluded for other congenital anomalies. Of the 494 remaining, 157 (32%) received CAP. There was no difference found in UTI incidence among those treated with CAP and those who were not.
AHRQ-funded; HS000063.
Citation: Varda BK, Finkelstein JB, Wang HH .
The association between continuous antibiotic prophylaxis and UTI from birth until initial postnatal imaging evaluation among newborns with antenatal hydronephrosis.
J Pediatr Urol 2018 Dec;14(6):539.e1-39.e6. doi: 10.1016/j.jpurol.2018.04.022..
Keywords: Antibiotics, Antimicrobial Stewardship, Urinary Tract Infection (UTI), Newborns/Infants, Imaging, Medication, Prevention
D'Agata EMC, Lindberg CC, Lindberg CM
The positive effects of an antimicrobial stewardship program targeting outpatient hemodialysis facilities.
The purpose of this study was to quantify the effect of an antimicrobial stewardship program in reducing antimicrobial prescribing. Implementation of the antimicrobial stewardship program was associated with a 6% monthly reduction in antimicrobial doses per 100 patient months during the intervention period (P=.02). The investigators found that within 6 hemodialysis facilities, implementation of an antimicrobial stewardship was associated with a decline in antimicrobial prescribing with no negative effects.
AHRQ-funded; HS021666.
Citation: D'Agata EMC, Lindberg CC, Lindberg CM .
The positive effects of an antimicrobial stewardship program targeting outpatient hemodialysis facilities.
Infect Control Hosp Epidemiol 2018 Dec;39(12):1400-05. doi: 10.1017/ice.2018.237..
Keywords: Antibiotics, Antimicrobial Stewardship, Prevention, Medication, Medication
Mundkur ML, Franklin J, Huybrechts KF
Changes in outpatient use of antibiotics by adults in the United States, 2006-2015.
The two goals of this observational study were to describe general trends in outpatient antibiotic use among adults from 2006 to 2015, and to identify rapid shifts in use during this time period as potential indicators for key events. Patients aged 18 years and older were selected from the Optum Clinformatics Datamart, a commercial insurance claims database; linear regression was used to identify trends in use over multiple years, and change-point regression was used to identify rapid shifts in use within individual years. Outpatient use of antibiotics from 2006 to 2015 decreased substantially among adults. Rapid shifts in use occurring in 2008 and 2013 may reflect the presence of key drivers of change.
AHRQ-funded; HS024930; 233201500020I.
Citation: Mundkur ML, Franklin J, Huybrechts KF .
Changes in outpatient use of antibiotics by adults in the United States, 2006-2015.
Drug Saf 2018 Dec;41(12):1333-42. doi: 10.1007/s40264-018-0697-4..
Keywords: Antibiotics, Healthcare Utilization, Medication, Practice Patterns
D'Agata EMC, Varu A, Geffert SF
Acquisition of multidrug-resistant organisms in the absence of antimicrobials.
This nested case-control study was conducted among 137 nursing home residents who did not receive antimicrobials, with 44 acquiring a multi-drug resistant organism. Risk factors identified included receiving gastrointestinal medication that affected the gut microbiome, the number of visits from healthcare workers, pressure ulcers, and not residing in a dementia unit.
AHRQ-funded; HS021666.
Citation: D'Agata EMC, Varu A, Geffert SF .
Acquisition of multidrug-resistant organisms in the absence of antimicrobials.
Clin Infect Dis 2018 Oct 15;67(9):1437-40. doi: 10.1093/cid/ciy358..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Nursing Homes, Long-Term Care, Elderly, Digestive Disease and Health, Case Study
Doernberg SB, Aboo LM, Burdette SD
Essential resources and strategies for antibiotic stewardship programs in the acute care setting.
This study measured the success of antibiotic stewardship programs to rates of antibiotic resistant disease. A survey was conducted of US stewardship programs using a cross-section of members of 3 infectious diseases subspecialty societies. Two-hundred forty-four respondents from a variety of acute care settings filled out the survey. Eighty-five percent of surveyed programs demonstrated at least 1 improved outcome in the prior 2 years. Every 0.50 increase in pharmacist and physician full-time equivalent (FTE) support predicted a 1.48-fold increase in demonstration effectiveness.
AHRQ-funded; HS023866.
Citation: Doernberg SB, Aboo LM, Burdette SD .
Essential resources and strategies for antibiotic stewardship programs in the acute care setting.
Clin Infect Dis 2018 Sep 28;67(8):1168-74. doi: 10.1093/cid/ciy255..
Keywords: Antimicrobial Stewardship, Antibiotics, Critical Care, Medication
Michener A, Heath B, Crnich CJ
Infections in older adults: a case-based discussion series emphasizing antibiotic stewardship.
This article describes the results of a series of 1-hour case-based discussions on recognition, diagnosis, and infections common in older adults, including those living in long-term care settings, and antibiotic stewardship that were developed by the authors. This series of five discussions was held at 15 Veterans Affairs medical centers in their skilled nursing centers. There were participants from an array of disciplines who completed an evaluation as well as pre- and post-course knowledge assessment. Total participants numbered from 68 to 108 per center. There were positive assessments, with many participants saying they were likely to make changes to help combat health associated infections.
AHRQ-funded; HS023866.
Citation: Michener A, Heath B, Crnich CJ .
Infections in older adults: a case-based discussion series emphasizing antibiotic stewardship.
MedEdPORTAL 2018 Sep 21;14:10754. doi: 10.15766/mep_2374-8265.10754..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Elderly, Infectious Diseases
D'Agata EMC, Tran D, Bautista J
Clinical and economic benefits of antimicrobial stewardship programs in hemodialysis facilities: a decision analytic model.
In this study, the authors developed a decision analytic model of antimicrobial use on the clinical and economic consequences of implementing a nationwide antimicrobial stewardship program in outpatient dialysis facilities. The authors found that the model suggested that implementation of antimicrobial stewardship programs in outpatient dialysis facilities would result in substantial reductions in infections caused by multidrug-resistant organisms and C. difficile, infection-related deaths, and costs.
AHRQ-funded; R18 HS021666.
Citation: D'Agata EMC, Tran D, Bautista J .
Clinical and economic benefits of antimicrobial stewardship programs in hemodialysis facilities: a decision analytic model.
Clin J Am Soc Nephrol 2018 Sep 7;13(9):1389-97. doi: 10.2215/cjn.12521117..
Keywords: Antimicrobial Stewardship, Shared Decision Making, Antibiotics, Medication, Healthcare Costs, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs)
Hostler CJ, Moehring RW, Ashley ESD
Feasibility and value of developing a regional antibiogram for community hospitals.
The purpose of this study was to determine the feasibility and value of developing a regional antibiogram for community hospitals. The investigators concluded that small community hospitals frequently cannot develop an accurate antibiogram due to a paucity of local data. They suggest that a regional antibiogram is likely to provide clinically useful information to community hospitals for low-prevalence pathogens.
AHRQ-funded; HS023866.
Citation: Hostler CJ, Moehring RW, Ashley ESD .
Feasibility and value of developing a regional antibiogram for community hospitals.
Infect Control Hosp Epidemiol 2018 Jun;39(6):718-22. doi: 10.1017/ice.2018.71..
Keywords: Antibiotics, Hospitals, Medication
McBride S, Thurm C, Gouripeddi R
Comparison of empiric antibiotics for acute osteomyelitis in children.
Broad-spectrum antibiotics are commonly used for the empiric treatment of acute hematogenous osteomyelitis and often target methicillin-resistant Staphylococcus aureus (MRSA) with medication-associated risk and unknown treatment benefit. In this study, the investigators aimed to compare clinical outcomes among patients with osteomyelitis who did and did not receive initial antibiotics used to target MRSA. The investigators found that, early antibiotic treatment used to target MRSA was associated with a higher rate of repeat MRI.
AHRQ-funded; HS019862.
Citation: McBride S, Thurm C, Gouripeddi R .
Comparison of empiric antibiotics for acute osteomyelitis in children.
Hosp Pediatr 2018 May;8(5):280-87. doi: 10.1542/hpeds.2017-0079..
Keywords: Children/Adolescents, Antibiotics, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Medication, Imaging, Patient Safety
Spellberg B
The maturing antibiotic mantra: "Shorter is still better."
The proper duration of antibiotic therapy for various infections is a matter of long-standing consternation. This article discusses the evidence supporting the idea that shorter courses of antibiotic therapy are as effective as longer courses. It asserts that shorter courses are better due to reduced exposure which intrinsically reduces the risk of adverse events and of selective pressure that drives resistance in our microbiomes.
AHRQ-funded; HS025690.
Citation: Spellberg B .
The maturing antibiotic mantra: "Shorter is still better."
J Hosp Med 2018 May;13(5):361.62. doi: 10.12788/jhm.2904.
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Keywords: Antibiotics, Care Management, Medication
Johnson SP, Zhong L, Chung KC
Perioperative antibiotics for clean hand surgery: a national study.
This research is a national study on the use of prophylactic antibiotics in soft tissue hand surgery when antimicrobials are not indicated. Insurance claims from the Truven MarketScan Databases were used to identify patients who had 1 of 5 outpatient surgery procedures including: open or endoscopic carpal tunnel release; trigger finger release; de Ouervain release, and wrist ganglion excision between 2009 and 2015. An increase of 72.5% in prophylactic intravenous antibiotics was shown from 2009 to 2015. Patients with a younger age, male sex, lower income, or obesity had higher odds of receiving antibiotics. Total charge for these antibiotics equaled $1.6 million.
AHRQ-funded; HS023313.
Citation: Johnson SP, Zhong L, Chung KC .
Perioperative antibiotics for clean hand surgery: a national study.
J Hand Surg Am 2018 May;43(5):407-16.e1. doi: 10.1016/j.jhsa.2017.11.018..
Keywords: Antibiotics, Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Infectious Diseases, Medication, Patient Safety, Surgery
Wald-Dickler N, Holtom P, Spellberg B
Busting the myth of "static vs cidal": a systemic literature review.
This study compared the effectiveness of bactericidal antibiotics versus bacteriostatic agents. A systematic literature review was conducted of published, randomized, controlled trials that were comparison studies. Of the 56 identified trials published since 1985, 49 found no significant difference in effectiveness between the two types of antibiotics. Only 1 trial found the bactericidal agent was superior.
AHRQ-funded; HS025690.
Citation: Wald-Dickler N, Holtom P, Spellberg B .
Busting the myth of "static vs cidal": a systemic literature review.
Clin Infect Dis 2018 Apr 17;66(9):1470-74. doi: 10.1093/cid/cix1127..
Keywords: Antibiotics, Medication, Comparative Effectiveness, Evidence-Based Practice
D'Agata EMC
Addressing the problem of multidrug-resistant organisms in dialysis.
This review examined the problem of multi-drug resistant organisms in patients on maintenance hemodialysis. It is common problem in patients on hemodialysis, with rates of colonization of multi-drug resistant organisms ranging from 3% to over 20%. A prospective cohort study of patients was conducted in one outpatient dialysis unit. The acquisition of these organisms occurred in 40% of patients, with 13% and 15% of patients acquiring MRSA and VRE respectively. Contamination came from dialysis machines and chairs, and also believed to come from healthcare workers as well. The study recommends implementing antimicrobial stewardship programs to improve antimicrobial prescribing patterns and decreasing health care costs. AHRQ is one of the agencies involved in this promotion and research effort.
AHRQ-funded; HS021666.
Citation: D'Agata EMC .
Addressing the problem of multidrug-resistant organisms in dialysis.
Clin J Am Soc Nephrol 2018 Apr 6;13(4):666-68. doi: 10.2215/cjn.13781217..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Healthcare-Associated Infections (HAIs)
Jump RLP, Crnich CJ, Mody L
Infectious diseases in older adults of long-term care facilities: update on approach to diagnosis and management.
The diagnosis, treatment, and prevention of infectious diseases in older adults in long-term care facilities (LTCFs), particularly nursing facilities, remains a challenge for all health providers who care for this population. This review provides updated information on the currently most important challenges of infectious diseases in LTCFs. With the increasing prescribing of antibiotics in older adults, particularly in LTCFs, the topic of antibiotic stewardship is presented in this review.
AHRQ-funded; HS022465.
Citation: Jump RLP, Crnich CJ, Mody L .
Infectious diseases in older adults of long-term care facilities: update on approach to diagnosis and management.
J Am Geriatr Soc 2018 Apr;66(4):789-803. doi: 10.1111/jgs.15248.
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Keywords: Elderly, Healthcare-Associated Infections (HAIs), Infectious Diseases, Nursing Homes, Long-Term Care, Antimicrobial Stewardship, Antibiotics, Medication, Evidence-Based Practice, Guidelines
Reeves SL, Tribble AC, Madden B
Antibiotic prophylaxis for children with sickle cell anemia.
This study calculated the proportion of children with sickle cell anemia (SCA) who received at least 300 days of antibiotic prophylaxis against invasive pneumococcal disease and identified predictors of receipt. Children with SCA between 3 months and 5 years old were identified by the presence of three or more Medicaid claims with a diagnosis of SCA within a calendar year in six states. Receipt of antibiotics was identified through claims for filled prescriptions. The authors conclude that antibiotic prophylaxis rates are low among children with SCA; more healthcare encounters may offer opportunities for increased intervention. Potential predictors were identified as age, sex, year, state, and health services usage.
AHRQ-funded; HS020516.
Citation: Reeves SL, Tribble AC, Madden B .
Antibiotic prophylaxis for children with sickle cell anemia.
Pediatrics 2018 Mar;141(3). doi: 10.1542/peds.2017-2182..
Keywords: Sickle Cell Disease, Children/Adolescents, Antibiotics, Prevention, Pneumonia, Medication