National Healthcare Quality and Disparities Report
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- Antibiotics (2)
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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 5 of 5 Research Studies DisplayedDeshpande A, Klompas M, Yu PC A, Klompas M, Yu PC
Influenza testing and treatment among patients hospitalized with community-acquired pneumonia.
This study looked at testing rates for influenza in hospitalized patients admitted for community-acquired pneumonia (CAP) and whether it is associated with antiviral treatment and shorter antibiotic courses. The study included patients admitted in 179 US hospitals with pneumonia from 2010 to 2015. The authors assessed influenza testing and compared antimicrobial utilization and the outcomes of test-positive, test-negative, and untested patients. Among 166,268 patients with CAP, 23.3% were tested for influenza, of whom 11.5% tested positive. Testing increased from 15.4% to 35.5% from 2010 to 2015 and was more than triple the rate during flu season (October-May) vs June to September. Patients who tested positive for influenza received antiviral agents more often and antibiotics less often and for shorter courses than patients testing negative. Patients who received early antiviral treatment with oseltamivir experienced lower 14-day in-hospital mortality, lower costs, and shorter length of stay vs patients receiving oseltamivir later or not at all.
AHRQ-funded; HS024277.
Citation: Deshpande A, Klompas M, Yu PC A, Klompas M, Yu PC .
Influenza testing and treatment among patients hospitalized with community-acquired pneumonia.
Chest 2022 Sep;162(3):543-55. doi: 10.1016/j.chest.2022.01.053..
Keywords: Influenza, Pneumonia, Community-Acquired Infections, Outcomes, Medication, Inpatient Care
Deshpande A, Richter SS, Haessler S
De-escalation of empiric antibiotics following negative cultures in hospitalized patients with pneumonia: rates and outcomes.
This study assessed antibiotic de-escalation practices across hospitals and their associations with outcomes in hospitalized patients diagnosed with pneumonia with negative cultures. The authors included 14,170 adults admitted with pneumonia in 2010-2015 to 164 US hospitals if they had negative blood and/or respiratory cultures and received both anti-MRSA and antipseudomonal agents other than quinolones. If empiric drugs were stopped on day 4 while continuing another antibiotic it was defined at de-escalation. Patients were propensity adjusted for de-escalation and compared on in-hospital 14-day mortality, late deterioration with ICU transfer, length-of-stay (LOS) and costs. Thirteen percent (1924 patients) had both initial empiric drugs stopped by hospital day 4. De-escalation rates at hospitals ranged from 2-35% and the established rate quartiles were not significantly associated with outcomes. Even at hospitals in the top quartile of de-escalation, the de-escalation rates were lower than 50%.
AHRQ-funded; HS025026; HS024277.
Citation: Deshpande A, Richter SS, Haessler S .
De-escalation of empiric antibiotics following negative cultures in hospitalized patients with pneumonia: rates and outcomes.
Clin Infect Dis 2021 Apr 26;72(8):1314-22. doi: 10.1093/cid/ciaa212..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Pneumonia, Respiratory Conditions, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Inpatient Care
Trent SA, Jarou ZJ, Havranek EP
Variation in emergency department adherence to treatment guidelines for inpatient pneumonia and sepsis: a retrospective cohort study.
Evidence-based clinical practice guidelines (CPGs) for the treatment of pneumonia and sepsis have existed for many years with multiple studies suggesting improved patient outcomes. Despite their importance, little is known about variation in emergency department (ED) adherence to these CPGs. The objectives of this study were to estimate variation in ED adherence across CPGs for pneumonia and sepsis and identify patient, provider, and environmental factors associated with adherence.
AHRQ-funded; HS022400.
Citation: Trent SA, Jarou ZJ, Havranek EP .
Variation in emergency department adherence to treatment guidelines for inpatient pneumonia and sepsis: a retrospective cohort study.
Acad Emerg Med 2019 Aug;26(8):908-20. doi: 10.1111/acem.13639.
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Keywords: Emergency Department, Evidence-Based Practice, Guidelines, Inpatient Care, Pneumonia, Sepsis
Trent SA, Havranek EP, Ginde AA
Effect of audit and feedback on physician adherence to clinical practice guidelines for pneumonia and sepsis.
This study examined the effect of feedback with blinded peer comparison on emergency physician adherence to guidelines for appropriate antibiotic administration for inpatient pneumonia and completion of the 3-hour Surviving Sepsis Bundle for patients with severe sepsis. A quasi-experiment was conducted with attending physicians randomized into 6 clusters at a single urban safety net hospital. Feedback with blinded peer comparison significantly improved guideline adherence from 52% to 65% with feedback.
AHRQ-funded; HS022400.
Citation: Trent SA, Havranek EP, Ginde AA .
Effect of audit and feedback on physician adherence to clinical practice guidelines for pneumonia and sepsis.
Am J Med Qual 2019 May/Jun;34(3):217-25. doi: 10.1177/1062860618796947..
Keywords: Antibiotics, Emergency Department, Guidelines, Infectious Diseases, Inpatient Care, Medication, Pneumonia, Provider, Provider: Physician, Sepsis
Desai NR, Ott LS, George EJ
Variation in and hospital characteristics associated with the value of care for Medicare beneficiaries with acute myocardial infarction, heart failure, and pneumonia.
The objectives of this study were to investigate the association between hospital-level 30-day risk-standardized mortality rates (RSMRs) and 30-day risk-standardized payments (RSPs) for acute myocardial infarction (AMI), heart failure (HF), and pneumonia (PNA); to characterize patterns of value in care; and to identify hospital characteristics associated with high-value care (defined by having lower than median RSMRs and RSPs).
AHRQ-funded; HS023000.
Citation: Desai NR, Ott LS, George EJ .
Variation in and hospital characteristics associated with the value of care for Medicare beneficiaries with acute myocardial infarction, heart failure, and pneumonia.
JAMA Netw Open 2018 Oct 5;1(6):e183519. doi: 10.1001/jamanetworkopen.2018.3519..
Keywords: Cardiovascular Conditions, Elderly, Hospitalization, Hospitals, Heart Disease and Health, Inpatient Care, Medicare, Mortality, Pneumonia