Abstract
To support antimicrobial stewardship, some healthcare systems have begun creating outpatient antibiograms. We developed inpatient and primary care outpatient antibiograms for a regional health maintenance organization (HMO) and academic healthcare system (AHS). Antimicrobial susceptibilities from 16,428 Enterococcus, Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa cultures from 2010 were summarized and compared. Methicillin susceptibility among S. aureus was similar in inpatients and primary care outpatients (HMO: 61.2% versus 61.9%, P = 0.951; AHS: 62.9% versus 63.3%, P > 0.999). E. coli susceptibility to trimethoprim/sulfamethoxazole was also similar (HMO: 81.8% versus 83.6%, P = 0.328; AHS: 77.2% versus 80.9%, P = 0.192), but ciprofloxacin susceptibility differed (HMO: 88.9% versus 94.6%, P <0.001; AHS: 81.2% versus 90.6%, P <0.001). In the HMO, ciprofloxacin-susceptible P. aeruginosa were more frequent in primary care outpatients than in inpatients (91.4% versus 79.0%, P = 0.007). Comparison of cumulative susceptibilities across settings yielded no consistent patterns; therefore, outpatient primary care antibiograms may more accurately inform prudent empiric antibiotic prescribing.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 73-79 |
| Number of pages | 7 |
| Journal | Diagnostic Microbiology and Infectious Disease |
| Volume | 76 |
| Issue number | 1 |
| DOIs | |
| State | Published - May 2013 |
Fingerprint
Keywords
- Ambulatory
- Antimicrobial stewardship
- Bacterial resistance
- Infectious disease
- Pharmacy practice
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases
Cite this
Comparison of antibiograms developed for inpatients and primary care outpatients. / McGregor, Jessina C.; Bearden, David T.; Townes, John; Sharp, Susan E.; Gorman, Paul; Elman, Miriam R.; Mori, Motomi (Tomi); Smith, David H.
In: Diagnostic Microbiology and Infectious Disease, Vol. 76, No. 1, 05.2013, p. 73-79.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparison of antibiograms developed for inpatients and primary care outpatients
AU - McGregor, Jessina C.
AU - Bearden, David T.
AU - Townes, John
AU - Sharp, Susan E.
AU - Gorman, Paul
AU - Elman, Miriam R.
AU - Mori, Motomi (Tomi)
AU - Smith, David H.
PY - 2013/5
Y1 - 2013/5
N2 - To support antimicrobial stewardship, some healthcare systems have begun creating outpatient antibiograms. We developed inpatient and primary care outpatient antibiograms for a regional health maintenance organization (HMO) and academic healthcare system (AHS). Antimicrobial susceptibilities from 16,428 Enterococcus, Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa cultures from 2010 were summarized and compared. Methicillin susceptibility among S. aureus was similar in inpatients and primary care outpatients (HMO: 61.2% versus 61.9%, P = 0.951; AHS: 62.9% versus 63.3%, P > 0.999). E. coli susceptibility to trimethoprim/sulfamethoxazole was also similar (HMO: 81.8% versus 83.6%, P = 0.328; AHS: 77.2% versus 80.9%, P = 0.192), but ciprofloxacin susceptibility differed (HMO: 88.9% versus 94.6%, P <0.001; AHS: 81.2% versus 90.6%, P <0.001). In the HMO, ciprofloxacin-susceptible P. aeruginosa were more frequent in primary care outpatients than in inpatients (91.4% versus 79.0%, P = 0.007). Comparison of cumulative susceptibilities across settings yielded no consistent patterns; therefore, outpatient primary care antibiograms may more accurately inform prudent empiric antibiotic prescribing.
AB - To support antimicrobial stewardship, some healthcare systems have begun creating outpatient antibiograms. We developed inpatient and primary care outpatient antibiograms for a regional health maintenance organization (HMO) and academic healthcare system (AHS). Antimicrobial susceptibilities from 16,428 Enterococcus, Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa cultures from 2010 were summarized and compared. Methicillin susceptibility among S. aureus was similar in inpatients and primary care outpatients (HMO: 61.2% versus 61.9%, P = 0.951; AHS: 62.9% versus 63.3%, P > 0.999). E. coli susceptibility to trimethoprim/sulfamethoxazole was also similar (HMO: 81.8% versus 83.6%, P = 0.328; AHS: 77.2% versus 80.9%, P = 0.192), but ciprofloxacin susceptibility differed (HMO: 88.9% versus 94.6%, P <0.001; AHS: 81.2% versus 90.6%, P <0.001). In the HMO, ciprofloxacin-susceptible P. aeruginosa were more frequent in primary care outpatients than in inpatients (91.4% versus 79.0%, P = 0.007). Comparison of cumulative susceptibilities across settings yielded no consistent patterns; therefore, outpatient primary care antibiograms may more accurately inform prudent empiric antibiotic prescribing.
KW - Ambulatory
KW - Antimicrobial stewardship
KW - Bacterial resistance
KW - Infectious disease
KW - Pharmacy practice
UR - http://www.scopus.com/inward/record.url?scp=84876728684&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84876728684&partnerID=8YFLogxK
U2 - 10.1016/j.diagmicrobio.2013.01.026
DO - 10.1016/j.diagmicrobio.2013.01.026
M3 - Article
C2 - 23541690
AN - SCOPUS:84876728684
VL - 76
SP - 73
EP - 79
JO - Diagnostic Microbiology and Infectious Disease
JF - Diagnostic Microbiology and Infectious Disease
SN - 0732-8893
IS - 1
ER -