{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T04:12:22Z","timestamp":1776053542622,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T00:00:00Z","timestamp":1605830400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Antibiotic overuse is associated with antibiotic resistance. We evaluated antibiotic utilization defined by days of therapy\/1000 patient days (DOT\/1000 PD) in various community hospitals across the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Community hospitals within the Cardinal Health Drug Cost Opportunity Analytics database were evaluated for the availability of DOT\/1000 PD data between 2012 to 2016 for overall and specific antibiotic use and the following classes: narrow\u2010spectrum \u03b2\u2010lactams (ampicillin, nafcillin, oxacillin, cefazolin, and cephalexin), non\u2010carbapenem antipseudomonal \u03b2\u2010lactams (piperacillin\/tazobactam, ceftazidime, and cefepime), carbapenems, anti\u2010methicillin\u2010resistant <jats:italic>Staphylococcus aureus<\/jats:italic> agents (vancomycin, linezolid, daptomycin, and tigecycline), and fluoroquinolones. Antibiotic utilization and change in utilization during the study period was calculated using linear regression (<jats:italic>\u03b2<\/jats:italic> coefficient).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighteen hospitals had antibiotic utilization data available. Hospitals were primarily urban (72%) with an average of 209 total beds and 22 intensive care unit beds. Mean number of pharmacists in these hospitals was nine with a mean pharmacist: bed ratio of 0.05. While all hospitals had antimicrobial stewardship programs established during the study period, only 78% and 22% had infectious diseases (ID) physician and ID pharmacist on staff, respectively. A decrease in antipseudomonal \u03b2\u2010lactams (excluding carbapenems) and fluoroquinolones was observed (<jats:italic>\u03b2<\/jats:italic> coefficients = \u22121.2 and \u22122.6, respectively), all other antibiotic classes had increased utilization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Overall antibiotic utilization increased over 5\u2009years. The increase in narrow\u2010spectrum \u03b2\u2010lactams utilization along with the reduction in the use of antipseudomonal \u03b2\u2010lactams and fluoroquinolones indicate appropriate antimicrobial stewardship. Institutional antibiotic utilization should be evaluated for appropriateness to limit the overuse of broad\u2010spectrum antibiotics in an effort to reduce resistance development.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.5156","type":"journal-article","created":{"date-parts":[[2020,10,23]],"date-time":"2020-10-23T11:01:00Z","timestamp":1603450860000},"page":"403-408","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Antibiotic utilization within 18 community hospitals in the United States: A 5\u2010year analysis"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0369-9094","authenticated-orcid":false,"given":"Abrar K.","family":"Thabit","sequence":"first","affiliation":[{"name":"Pharmacy Practice Department, Faculty of Pharmacy King Abdulaziz University  Jeddah Saudi Arabia"},{"name":"Cardinal Health  Houston Texas USA"},{"name":"University of Houston College of Pharmacy  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine M.","family":"Shea","sequence":"additional","affiliation":[{"name":"Cardinal Health  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oscar E.","family":"Guzman","sequence":"additional","affiliation":[{"name":"Cardinal Health  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin W.","family":"Garey","sequence":"additional","affiliation":[{"name":"University of Houston College of Pharmacy  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,20]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Antibiotic resistance threats in the United States, 2013","author":"Centers for Disease Control and Prevention (CDC)","year":"2013"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.2015.993381"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2011.09.005"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.2307\/30141013"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3182836dc2"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1086\/677835"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1086\/665010"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw118"},{"key":"e_1_2_8_10_1","unstructured":"The Joint Commission on Accreditation of Healthcare Organizations.New Antimicrobial Stewardship Standard. Medication Management (MM). Vol MM.09.01.012016."},{"key":"e_1_2_8_11_1","unstructured":"Hospital Conditions of Participation 23 CFR \u00a7482.23(c)(2) (2016)."},{"key":"e_1_2_8_12_1","volume-title":"The Core Elements of Hospital Antibiotic Stewardship Programs: 2019","author":"Centers for Disease Control and Prevention","year":"2019"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu546"},{"key":"e_1_2_8_14_1","unstructured":"National Quality Forum.National Quality Partners antibiotic stewardship action team. 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