National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- (-) Antibiotics (12)
- Antimicrobial Stewardship (4)
- (-) Clostridium difficile Infections (12)
- Decision Making (2)
- Elderly (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (9)
- Healthcare Costs (1)
- Hospital Discharge (1)
- Hospital Readmissions (1)
- Hospitals (1)
- Infectious Diseases (1)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (1)
- Medication (6)
- Patient Safety (3)
- Policy (1)
- Practice Patterns (1)
- Prevention (4)
- Quality Improvement (1)
- Quality of Care (1)
- Treatments (1)
- Urinary Tract Infection (UTI) (1)
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 12 of 12 Research Studies DisplayedButler AM, Durkin MJ, Keller MR
Association of adverse events with antibiotic treatment for urinary tract infection.
The purpose of this study was to compare the risk of relative harms associated with different antibiotics prescribed for the treatment of uncomplicated urinary tract infection (UTI). The researchers identified 1,169,033 healthy, nonpregnant women between the ages of 18 to 44 who had an uncomplicated UTI and who initiated an oral antibiotic regimen for the treatment of common uropathogens between July 2006 and September 2015. The study found that of the two first-line treatments, the drug trimethoprim-sulfamethoxazole (versus nitrofurantoin) was associated with a higher risk of adverse drug-related events including: hypersensitivity, acute renal failure, skin rash, urticaria, abdominal pain, and nausea/ vomiting, but a similar risk of adverse possible microbiome-related events. When researchers compared non-first line drugs with nitrofurantoin, the non-first line drugs were associated with a greater risk of adverse drug events and possible microbiome-related adverse events including non-Clostridium difficile diarrhea, C. difficile infection, vaginitis/vulvovaginal candidiasis, and pneumonia. The duration of the treatment influenced the risk of possible microbiome-related adverse events. The study concluded that the risk of adverse events differs widely by both antibiotic drug and duration of regimen.
AHRQ-funded; HS019455.
Citation: Butler AM, Durkin MJ, Keller MR .
Association of adverse events with antibiotic treatment for urinary tract infection.
Clin Infect Dis 2022 Apr 28;74(8):1408-18. doi: 10.1093/cid/ciab637..
Keywords: Antibiotics, Medication, Urinary Tract Infection (UTI), Adverse Drug Events (ADE), Adverse Events, Clostridium difficile Infections
Safdar N, Parmasad V, Brown R
Decreasing ICU-associated Clostridioides difficile infection through fluoroquinolone restriction, the FIRST trial: a study protocol.
Clostridioides difficile infection (CDI) is one of the most common healthcare-associated infections in the USA, having high incidence in intensive care units (ICU). Antibiotic use increases risk of CDI, with fluoroquinolones (FQs) particularly implicated. In healthcare settings, antibiotic stewardship (AS) and infection control interventions are effective in CDI control, but there is little evidence regarding the most effective AS interventions. In this paper the investigators describe their multisite, stepped-wedge, cluster, effectiveness-implementation clinical trial.
AHRQ-funded; R01 HS026226.
Citation: Safdar N, Parmasad V, Brown R .
Decreasing ICU-associated Clostridioides difficile infection through fluoroquinolone restriction, the FIRST trial: a study protocol.
BMJ Open 2021 Jun 29;11(6):e046480. doi: 10.1136/bmjopen-2020-046480..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Antimicrobial Stewardship, Antibiotics, Medication, Prevention
Tamma PD, Miller MA, Dullabh P
AHRQ Author: Miller MA
Association of a safety program for improving antibiotic use with antibiotic use and hospital-onset Clostridioides difficile infection rates among US hospitals.
Regulatory agencies and professional organizations recommend antibiotic stewardship programs (ASPs) in US hospitals. The optimal approach to establish robust, sustainable ASPs across diverse hospitals is unknown. The purpose of this study was to assess whether the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Antibiotic Use was associated with reductions in antibiotic use across US hospitals. The investigators concluded that AHRQ Safety Program appeared to enable diverse hospitals to establish ASPs and teach frontline clinicians to self-steward their antibiotic use.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Tamma PD, Miller MA, Dullabh P .
Association of a safety program for improving antibiotic use with antibiotic use and hospital-onset Clostridioides difficile infection rates among US hospitals.
JAMA Netw Open 2021 Feb;4(2):e210235. doi: 10.1001/jamanetworkopen.2021.0235..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Decision Making, Clostridium difficile Infections, Patient Safety, Quality Improvement, Quality of Care, Hospitals
Bowman JA, Utter GH
Evolving strategies to manage Clostridium difficile colitis.
The authors discuss Clostridium difficile infection and diagnostic methods and treatment strategies evolved in recent years. They indicate that oral or enteral vancomycin is now preferred for first-line antimicrobial treatment across the disease spectrum, including mild to moderate initial cases. Further, fidaxomicin, bezlotoxumab, and fecal microbiota transplantation expand the therapeutic armamentarium, with operative treatment being reserved for patients with fulminant infection. They add that early identification of patients who would benefit from an operation remains a challenge.
AHRQ-funded; HS022236.5rf2c
Citation: Bowman JA, Utter GH .
Evolving strategies to manage Clostridium difficile colitis.
J Gastrointest Surg 2020 Feb;24(2):484-91. doi: 10.1007/s11605-019-04478-5..
Keywords: Clostridium difficile Infections, Infectious Diseases, Healthcare-Associated Infections (HAIs), Antibiotics, Medication, Treatments
Caroff DA, Menchaca JT, Zhang Z
Oral vancomycin prophylaxis during systemic antibiotic exposure to prevent Clostridiodes difficile infection relapses.
This study’s goal was to determine if giving hospitalized patients oral vancomycin along with systematic antibiotics prevents relapse of Cloistridioides difficile infection (CDI). The results show that the outcome was not statistically significant, although it may help patients who have only had 1 prior CDI episode.
AHRQ-funded; HS025008.
Citation: Caroff DA, Menchaca JT, Zhang Z .
Oral vancomycin prophylaxis during systemic antibiotic exposure to prevent Clostridiodes difficile infection relapses.
Infect Control Hosp Epidemiol 2019 Jun;40(6):662-67. doi: 10.1017/ice.2019.88..
Keywords: Antibiotics, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Medication, Prevention
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, Decision Making, Antibiotics, Medication, Healthcare Costs, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs)
Psoinos CM, Collins CE, Ayturk MD
Post-hospitalization treatment regimen and readmission for C. difficile colitis in Medicare beneficiaries.
C. difficile (CDI) has surpassed methicillin-resistant staph aureus as the most common nosocomial infection with recurrence reaching 30% and the elderly being disproportionately affected. The authors hypothesized that post-discharge antibiotic therapy for continued CDI treatment reduces readmissions. The study concluded that patients discharged with single-drug therapy for CDI had lower readmission rates compared to patients discharged on no ongoing CDI treatment suggesting that short-term monotherapy may be beneficial in inducing eradication and preventing relapse.
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AHRQ-funded; HS022694
Citation: Psoinos CM, Collins CE, Ayturk MD .
Post-hospitalization treatment regimen and readmission for C. difficile colitis in Medicare beneficiaries.
World J Surg 2018 Jan;42(1):246-53. doi: 10.1007/s00268-017-4139-8..
Keywords: Antibiotics, Clostridium difficile Infections, Elderly, Hospital Discharge, Hospital Readmissions
Jump RLP, Gaur S, Katz MJ
Template for an antibiotic stewardship policy for post-acute and long-term care settings.
To support compliance with Centers for Medicare and Medicaid services (CMS) requirements and aid facilities in establishing a stewardship program, the Infection Advisory Committee at the American Medical Directors Association -The Society for Post-Acute and Long-Term Care Medicine, has developed an antibiotic stewardship policy template tailored to the long-term care setting. This paper describes that policy template.
AHRQ-funded; HS022465; HS023779.
Citation: Jump RLP, Gaur S, Katz MJ .
Template for an antibiotic stewardship policy for post-acute and long-term care settings.
J Am Med Dir Assoc 2017 Nov;18(11):913-20. doi: 10.1016/j.jamda.2017.07.018..
Keywords: Antibiotics, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Policy, Prevention
Seidelman J, Dicks KV, Durkin MJ
Using clinical scenarios to understand preventability of Clostridium difficile infections by inpatient antibiotic stewardship programs.
The authors of this research brief designed a 2-phase study (1) to define the types of clostridium difficile infections (CDI) that clinicians consider unlikely preventable by inpatient antibiotic stewardship programs and (2) to estimate the relative proportion of inpatient CDI cases at a tertiary-care hospital that belongs to this category of “nonpreventable” CDI.
AHRQ-funded; HS023866.
Citation: Seidelman J, Dicks KV, Durkin MJ .
Using clinical scenarios to understand preventability of Clostridium difficile infections by inpatient antibiotic stewardship programs.
Infect Control Hosp Epidemiol 2017 Jun;38(6):747-49. doi: 10.1017/ice.2017.32..
Keywords: Antibiotics, Antimicrobial Stewardship, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Inpatient Care
Slayton RB, Toth D, Lee BY
Vital signs: estimated effects of a coordinated approach for action to reduce antibiotic-resistant infections in health care facilities - United States.
The researchers analyzed data from CDC's National Healthcare Safety Network and Emerging Infections Program to project the number of health care-associated infections (HAIs) from antibiotic-resistant bacteria or C. difficile both with and without a large scale national intervention that would include interrupting transmission and improved antibiotic stewardship. They found that, with effective action now, more than half a million antibiotic-resistant HAIs could be prevented over 5 years and that a coordinated approach to interrupting transmission is more effective than historical independent facility-based efforts.
AHRQ-funded; HS023317.
Citation: Slayton RB, Toth D, Lee BY .
Vital signs: estimated effects of a coordinated approach for action to reduce antibiotic-resistant infections in health care facilities - United States.
MMWR Morb Mortal Wkly Rep 2015 Aug 7;64(30):826-31.
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Keywords: Antibiotics, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Ostrowsky B, Ruiz R, Brown S
Lessons learned from implementing Clostridium difficile-focused antibiotic stewardship interventions.
The researchers sought to determine whether controlling the prescription of targeted antibiotics would translate to a measurable reduction in hospital-onset Clostridium difficile infection (CDI) rates. They found that decreases in target antibiotic consumption did not translate into reductions of hospital-onset CDI in this study, but many valuable lessons were learned.
AHRQ-funded; 290200600012I.
Citation: Ostrowsky B, Ruiz R, Brown S .
Lessons learned from implementing Clostridium difficile-focused antibiotic stewardship interventions.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S86-95. doi: 10.1086/677828.
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Keywords: Antibiotics, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety
Pakyz AL, Ozcan YA
Use of data envelopment analysis to quantify opportunities for antibacterial targets for reduction of health care-associated Clostridium difficile infection.
The authors conducted a cross-sectional study using claims data from 58 hospitals to create a benchmark strategy targeting high-risk antibacterials for C difficile. Seventeen hospitals were identified as best-practice hospitals. They found that the antibacterial classes requiring the greatest percentage reduction in use in non-best-practice hospitals versus best-practice hospitals were clindamycin, β-lactam/β-lactamase combinations, and carbapenems.
AHRQ-funded; HS018578.
Citation: Pakyz AL, Ozcan YA .
Use of data envelopment analysis to quantify opportunities for antibacterial targets for reduction of health care-associated Clostridium difficile infection.
Am J Med Qual 2014 Sep-Oct;29(5):437-44. doi: 10.1177/1062860613502520.
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Keywords: Antibiotics, Clostridium difficile Infections, Guidelines, Healthcare-Associated Infections (HAIs), Practice Patterns