National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- (-) Adverse Drug Events (ADE) (7)
- Adverse Events (4)
- Antibiotics (4)
- (-) Antimicrobial Stewardship (7)
- Children/Adolescents (1)
- Chronic Conditions (2)
- Clinical Decision Support (CDS) (1)
- Critical Care (1)
- Decision Making (1)
- Dental and Oral Health (1)
- Dialysis (1)
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- Elderly (1)
- Intensive Care Unit (ICU) (1)
- Kidney Disease and Health (2)
- Medication (5)
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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 7 of 7 Research Studies DisplayedGross AE, Suda KJ, Zhou J
Serious antibiotic-related adverse effects following unnecessary dental prophylaxis in the United States.
The majority of antibiotics prescribed before a dental visit are considered unnecessary (80.9%). This study characterized adverse effects related to unnecessary dental prophylaxis. This retrospective cohort study used data from dental visits between 2011 and 2015 from the IBM Watson Health Marketscan Commercial Claims/Encounters, Medicare Supplemental, Coordination of Benefits Research databases. Antibiotics prescribed included amoxicillin (67.9%), clindamycin (15.5%), cephalexin (8.6%), azithromycin (2.8%), and penicillin (1.5). Antibiotic adverse effects (AAEs) were found in 1.4% of unnecessary prescriptions. The most common AAEs were emergency department (ED) visits, allergic reactions, 14 cases of C. difficile infection, and 5 anaphylactic reactions. AAEs were more common with clindamycin than amoxicillin.
AHRQ-funded; HS025177.
Citation: Gross AE, Suda KJ, Zhou J .
Serious antibiotic-related adverse effects following unnecessary dental prophylaxis in the United States.
Infect Control Hosp Epidemiol 2021 Jan;42(1):110-12. doi: 10.1017/ice.2020.1261..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Dental and Oral Health, Adverse Drug Events (ADE), Adverse Events
Daniel VT, Francalancia S, Amir NS
Upper gastrointestinal perforations: a possible danger of antibiotic overuse.
Investigators conducted a retrospective case-control study to examine the relationship between antibiotic exposure and upper gastrointestinal (UGI) perforations in a national sample. A 5% random sample of Medicare were queried to identify patients at least 65 years old who were hospitalized with stomach or small intestine UGI perforations using International Classification of Diseases diagnosis codes; Cases with UGI perforations were matched with 4 controls based on age and sex. The investigators concluded that recent outpatient antibiotic use, in particular in the preceding 30 days, is associated with UGI perforation among Medicare beneficiaries. They recommended minimizing exposure to antibiotics in the outpatient setting.
AHRQ-funded; HS022694.
Citation: Daniel VT, Francalancia S, Amir NS .
Upper gastrointestinal perforations: a possible danger of antibiotic overuse.
J Gastrointest Surg 2020 Dec;24(12):2730-36. doi: 10.1007/s11605-019-04473-w..
Keywords: Digestive Disease and Health, Antimicrobial Stewardship, Antibiotics, Medication, Adverse Drug Events (ADE), Adverse Events
Pulia MS, Keller SC, Crnich CJ
Antibiotic stewardship for older adults in ambulatory care settings: addressing an unmet challenge.
Inappropriate antibiotic use is common in older adults (aged >65 y), and they are particularly vulnerable to serious antibiotic-associated adverse effects such as cardiac arrhythmias, delirium, aortic dissection, drug-drug interactions, and Clostridioides difficile. In this study, to help improve the clinical care of older adults, the investigators reviewed drivers of antibiotic prescribing in this population, explored systems aspects of ambulatory care that can create barriers to optimal antibiotic use, discussed existing stewardship interventions, and provided guidance on priority areas for future inquiry.
AHRQ-funded; HS024342.
Citation: Pulia MS, Keller SC, Crnich CJ .
Antibiotic stewardship for older adults in ambulatory care settings: addressing an unmet challenge.
J Am Geriatr Soc 2020 Feb;68(2):244-49. doi: 10.1111/jgs.16256..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Elderly, Patient Safety, Adverse Drug Events (ADE), Adverse Events
Woods-Hill CZ, Koontz DW, King AF
Practices, perceptions, and attitudes in the evaluation of critically ill children for bacteremia: a national survey.
Sending blood cultures in children at low risk of bacteremia can contribute to a cascade of unnecessary antibiotic exposure, adverse effects, and increased costs. In this study, the investigators aimed to describe practice variation, clinician beliefs, and attitudes about blood culture testing in critically ill children. They concluded that there is variation in blood culture practices in the pediatric ICU. Fear and reflexive habits are common drivers of cultures. These practices may contribute to over-testing for bacteremia.
AHRQ-funded; HS025642.
Citation: Woods-Hill CZ, Koontz DW, King AF .
Practices, perceptions, and attitudes in the evaluation of critically ill children for bacteremia: a national survey.
Pediatr Crit Care Med 2020 Jan;21(1):e23-e29. doi: 10.1097/pcc.0000000000002176..
Keywords: Children/Adolescents, Critical Care, Antimicrobial Stewardship, Antibiotics, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Intensive Care Unit (ICU), Decision Making
Snyder GM, McCoy C, D'Agata EM
Quantifying antimicrobial exposure: hazards in populations with end-stage renal disease.
Using a rigorously collected data set of antimicrobial use among patients receiving chronic hemodialysis, antimicrobial use was calculated using 3 different methodologies: daily defined dose, days of therapy, and start-stop days. Estimates of antimicrobial use varied by as much as 10-fold, depending on the type of antimicrobial.
AHRQ-funded; HS021666.
Citation: Snyder GM, McCoy C, D'Agata EM .
Quantifying antimicrobial exposure: hazards in populations with end-stage renal disease.
Infect Control Hosp Epidemiol 2017 Mar;38(3):360-63. doi: 10.1017/ice.2016.290.
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Keywords: Adverse Drug Events (ADE), Antimicrobial Stewardship, Dialysis, Kidney Disease and Health, Patient Safety
Lo Re V, 3rd, Carbonari DM, Lewis JD
Oral azole antifungal medications and risk of acute liver injury, overall and by chronic liver disease status.
The researchers evaluated incidence rates of acute liver injury associated with oral azole antifungals. They concluded that rates of acute liver injury were similarly low for fluconazole, ketoconazole, and itraconazole. Events were more common among voriconazole and posaconazole users but were comparable. Pre-existing chronic liver disease increased risk of azole-induced liver injury.
AHRQ-funded; HS018372.
Citation: Lo Re V, 3rd, Carbonari DM, Lewis JD .
Oral azole antifungal medications and risk of acute liver injury, overall and by chronic liver disease status.
Am J Med 2016 Mar;129(3):283-91.e5. doi: 10.1016/j.amjmed.2015.10.029.
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Keywords: Antimicrobial Stewardship, Medication, Kidney Disease and Health, Chronic Conditions, Adverse Drug Events (ADE)
Lo Re V, 3rd, Haynes K, Forde KA
Risk of acute liver failure in patients with drug-induced liver injury: evaluation of Hy's Law and a new prognostic model.
The researchers aimed to develop a highly sensitive model to identify drug-induced liver injury (DILI) patients at increased risk of acute liver failure (ALF). negative predictive value (0.99), but low level of sensitivity (0.68) and positive predictive value (0.02). Their model, comprising data on platelet count and total bilirubin level, identified patients with ALF with a C statistic of 0.87 and enabled calculation of a risk score (Drug-Induced Liver Toxicity ALF Score).
AHRQ-funded; HS018372.
Citation: Lo Re V, 3rd, Haynes K, Forde KA .
Risk of acute liver failure in patients with drug-induced liver injury: evaluation of Hy's Law and a new prognostic model.
Clin Gastroenterol Hepatol 2015 Dec;13(13):2360-8. doi: 10.1016/j.cgh.2015.06.020.
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Keywords: Antimicrobial Stewardship, Medication, Chronic Conditions, Adverse Drug Events (ADE), Clinical Decision Support (CDS)