{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T18:33:12Z","timestamp":1768069992473,"version":"3.49.0"},"reference-count":40,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2015,10,12]],"date-time":"2015-10-12T00:00:00Z","timestamp":1444608000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec id=\"S0899823X15002263_abs1\" sec-type=\"general\"><jats:title>BACKGROUND<\/jats:title><jats:p>To design better antimicrobial stewardship programs, detailed data on the primary drivers and patterns of antibiotic use are needed.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15002263_abs2\" sec-type=\"general\"><jats:title>OBJECTIVE<\/jats:title><jats:p>To characterize the indications for antibiotic therapy, agents used, duration, combinations, and microbiological justification in 6 acute-care US facilities with varied location, size, and type of antimicrobial stewardship programs.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15002263_abs3\" sec-type=\"general\"><jats:title>DESIGN, PARTICIPANTS, AND SETTING<\/jats:title><jats:p>Retrospective medical chart review was performed on a random cross-sectional sample of 1,200 adult inpatients, hospitalized (&gt;24 hrs) in 6 hospitals, and receiving at least 1 antibiotic dose on 4 index dates chosen at equal intervals through a 1-year study period (October 1, 2009\u2013September 30, 2010).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15002263_abs4\" sec-type=\"methods\"><jats:title>METHODS<\/jats:title><jats:p>Infectious disease specialists recorded patient demographic characteristics, comorbidities, microbiological and radiological testing, and agents used, dose, duration, and indication for antibiotic prescriptions.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15002263_abs5\" sec-type=\"results\"><jats:title>RESULTS<\/jats:title><jats:p>On the index dates 4,119 (60.5%) of 6,812 inpatients were receiving antibiotics. The random sample of 1,200 case patients was receiving 2,527 antibiotics (average: 2.1 per patient); 540 (21.4%) were prophylactic and 1,987 (78.6%) were therapeutic, of which 372 (18.7%) were pathogen-directed at start. Of the 1,615 empirical starts, 382 (23.7%) were subsequently pathogen-directed and 1,231 (76.2%) remained empirical. Use was primarily for respiratory (27.6% of prescriptions) followed by gastrointestinal (13.1%) infections. Fluoroquinolones, vancomycin, and antipseudomonal penicillins together accounted for 47.1% of therapy-days.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X15002263_abs6\" sec-type=\"conclusions\"><jats:title>CONCLUSIONS<\/jats:title><jats:p>Use of broad-spectrum empirical therapy was prevalent in 6 US acute care facilities and in most instances was not subsequently pathogen directed. Fluoroquinolones, vancomycin, and antipseudomonal penicillins were the most frequently used antibiotics, particularly for respiratory indications.<\/jats:p><jats:p><jats:italic>Infect. Control Hosp. Epidemiol.<\/jats:italic> 2015;37(1):70\u201379<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2015.226","type":"journal-article","created":{"date-parts":[[2015,10,12]],"date-time":"2015-10-12T22:42:27Z","timestamp":1444689747000},"page":"70-79","source":"Crossref","is-referenced-by-count":42,"title":["Indications and Types of Antibiotic Agents Used in 6 Acute Care Hospitals, 2009\u20132010: A Pragmatic Retrospective Observational Study"],"prefix":"10.1017","volume":"37","author":[{"given":"Theodoros","family":"Kelesidis","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolay","family":"Braykov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel Z.","family":"Uslan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel J.","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumanth","family":"Gandra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgir","family":"Johannsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marin L.","family":"Schweizer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott A.","family":"Weisenberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Young","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Cantey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eli","family":"Perencevich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Septimus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arjun","family":"Srinivasan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramanan","family":"Laxminarayan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2015,10,12]]},"reference":[{"key":"S0899823X15002263_ref15","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0014011"},{"key":"S0899823X15002263_ref23","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-0842"},{"key":"S0899823X15002263_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2004.09.014"},{"key":"S0899823X15002263_ref17","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.8.972"},{"key":"S0899823X15002263_ref10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.12923"},{"key":"S0899823X15002263_ref4","doi-asserted-by":"publisher","DOI":"10.1086\/658946"},{"key":"S0899823X15002263_ref33","first-page":"CD003543","article-title":"Interventions to improve antibiotic prescribing practices for hospital inpatients","volume":"4","author":"Davey","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"S0899823X15002263_ref1","unstructured":"World Health Organization (WHO). 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