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Correlates of Antibiotic Use in Taiwan Hospitals

Published online by Cambridge University Press:  02 January 2015

L. Clifford McDonald ,
Hui Tzu Yu ,
Hsiao Chun Yin ,
Chao Agnes Hsiung ,
Chien-Ching Hung ,
Monto Ho  and
Antibiotic Use Working Group
L. Clifford McDonald
Affiliation:
Division of Clinical Research, Taipei, Taiwan
Hui Tzu Yu
Affiliation:
Division of Biostatistics, Taipei, Taiwan
Hsiao Chun Yin
Affiliation:
Division of Clinical Research, Taipei, Taiwan
Chao Agnes Hsiung
Affiliation:
Division of Biostatistics, Taipei, Taiwan
Chien-Ching Hung
Affiliation:
National Health Research Institutes, National Taiwan University Hospital, Taipei, Taiwan
Monto Ho*
Affiliation:
Division of Clinical Research, Taipei, Taiwan
*
Division of Clinical Research, National Health Research Institutes, 128 Yen-Chiu-Yuan Rd, Sec 2, Taipei 11529, Taiwan, Republic of China
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Abstract

Objective:

To determine factors that correlate with increased antibiotic use among adult inpatients in Taiwan.

Design:

Retrospective survey of medical records.

Setting:

14 acute-care hospitals (8 regional hospitals, 6 medical centers) in Taiwan.

Participants:

A systematic probability sample from each hospital, totaling 663 adult inpatients who were discharged or had died in early 1999.

Measurements:

Infectious disease physicians at the 14 hospitals collected data from medical records regarding patient demographics, hospitalization, discharge diagnosis, and antibiotics received.

Results:

A total of 447 (67%) patients received antibiotics for an overall rate of 813 antibiotic-days (number of days patients received each antibiotic)/1,000 patient-days. Both the proportion of beds in intensive care units ([ICUs] Pearson correlation coefficient [r], 0.67; 95% confidence interval [CI95], 0.36-0.89; P<.01) and the proportion of patients admitted to surgical services (r, 0.66; CI95, 0.20-0.88; P=.01) correlated with the mean patient rate of antibiotic-days/hospital-day (MPAUD). In contrast, we found no correlation between the proportion of patients who received antibiotics and the MPAUD. Using multiple linear regression, medical center status was the only independent predictor for increased MPAUD (regression coefficient [b], 0.15; CI95, 0.05-0.24; P<.01). There was no correlation between pooled rates of antibiotic-days/hospital-day and any hospital demographic factors. First-generation cephalosporin (39%) and aminoglycoside (24%) use accounted for the majority of antibiotic-days.

Conclusions:

Antibiotic use is greater in medical centers than in regional hospitals and appears to be independent of surgical case mix or the proportion of ICU beds. Determination of multiple, independent measures of antibiotic use may be necessary to understand the relation between antibiotic use and resistance in hospitals.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 9 , September 2001 , pp. 565 - 571
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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