caa a22 4500 606156070 CHVBK 20210128100606.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s10096-015-2378-x doi (NATIONALLICENCE)springer-10.1007/s10096-015-2378-x Evaluating antibiotic stewardship programs in patients with bacteremia using administrative data: a cohort study [Elektronische Daten] [J. Boel, M. Søgaard, V. Andreasen, J. Jarløv, M. Arpi] When introducing new antibiotic guidelines for empirical treatment of bacteremia, it is imperative to evaluate the performance of the new guideline. We examined the utility of administrative data to evaluate the effect of new antibiotic guidelines and the prognostic impact of appropriate empirical treatment. We categorized 2,008 adult patients diagnosed with bacteremia between 2010 and 2012 according to whether they received cephalosporins or fluoroquinolones (old regimen) or not (new regimen). We used administrative data to extract individual level data on mortality, readmission, and appropriateness of treatment, and computed adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for 30-day mortality and post-discharge readmission by regimen and appropriateness of treatment. In total, 945 (47.1%) were treated by the old regimen and 1,063 (52.9%) by the new. The median length of stay (8days) did not differ by regimen and neither did the proportion of those receiving appropriate empirical treatment (84.1% vs. 85.5%). However, fewer patients with the new regimen were admitted to the intensive care unit (ICU; 3.8% vs. 12.0%) and they had lower 30-day mortality (16.4% vs. 23.4%). The adjusted 30-day mortality HR for appropriate versus inappropriate treatment was 0.79 (95% CI 0.62-1.01) and 0.83 (95% CI 0.66-1.05) for the new versus the old regimen. The HR for 30-day readmission for appropriate versus inappropriate treatment was 0.91 (95% CI 0.73-1.13) and 1.05 (95% CI 0.87-1.25) for the new versus the old regimen. This study demonstrates that administrative data can be useful for evaluating the effect and quality of new bacteremia treatment guidelines. Springer-Verlag Berlin Heidelberg, 2015 Boel J. Department of Clinical Microbiology, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark aut Søgaard M. Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark aut Andreasen V. Department of Science, Systems and Models, Roskilde University, Roskilde, Denmark aut Jarløv J. Department of Clinical Microbiology, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark aut Arpi M. Department of Clinical Microbiology, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/7(2015-07-01), 1475-1484 0934-9723 34:7<1475 2015 34 10096 https://doi.org/10.1007/s10096-015-2378-x text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-015-2378-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Boel J. Department of Clinical Microbiology, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark aut NATIONALLICENCE 700 1- Søgaard M. Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark aut NATIONALLICENCE 700 1- Andreasen V. Department of Science, Systems and Models, Roskilde University, Roskilde, Denmark aut NATIONALLICENCE 700 1- Jarløv J. Department of Clinical Microbiology, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark aut NATIONALLICENCE 700 1- Arpi M. Department of Clinical Microbiology, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/7(2015-07-01), 1475-1484 0934-9723 34:7<1475 2015 34 10096