{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T17:03:34Z","timestamp":1778519014070,"version":"3.51.4"},"reference-count":25,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T00:00:00Z","timestamp":1617667200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X21000830_as1\"><jats:title>Objective:<\/jats:title><jats:p>To determine whether cascade reporting is associated with a change in meropenem and fluoroquinolone consumption.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21000830_as2\"><jats:title>Design:<\/jats:title><jats:p>A quasi-experimental study was conducted using an interrupted time series to compare antimicrobial consumption before and after the implementation of cascade reporting.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21000830_as3\"><jats:title>Setting:<\/jats:title><jats:p>A 399-bed, tertiary-care, Veterans\u2019 Affairs medical center.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21000830_as4\"><jats:title>Participants:<\/jats:title><jats:p>Antimicrobial consumption data across 8 inpatient units were extracted from the Center for Disease Control and Prevention (CDC) National Health Safety Network (NHSN) antimicrobial use (AU) module from April 2017 through March 2019, reported as antimicrobial days of therapy (DOT) per 1,000 days present (DP).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21000830_as5\"><jats:title>Intervention:<\/jats:title><jats:p>Cascade reporting is a strategy of reporting antimicrobial susceptibility test results in which secondary agents are only reported if an organism is resistant to primary, narrow-spectrum agents. A multidisciplinary team developed cascade reporting algorithms for gram-negative bacteria based on local antibiogram and infectious diseases practice guidelines, aimed at restricting the use of fluoroquinolones and carbapenems. The algorithms were implemented in March 2018.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21000830_as6\"><jats:title>Results:<\/jats:title><jats:p>Following the implementation of cascade reporting, mean monthly meropenem (<jats:italic>P<\/jats:italic> =.005) and piperacillin\/tazobactam (<jats:italic>P<\/jats:italic> = .002) consumption decreased and cefepime consumption increased (<jats:italic>P<\/jats:italic> &lt; .001). Ciprofloxacin consumption decreased by 2.16 DOT per 1,000 DP per month (SE, 0.25; <jats:italic>P<\/jats:italic> &lt; .001). <jats:italic>Clostridioides difficile<\/jats:italic> rates did not significantly change.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21000830_as7\"><jats:title>Conclusion:<\/jats:title><jats:p>Ciprofloxacin consumption significantly decreased after the implementation of cascade reporting. Mean meropenem consumption decreased after cascade reporting was implemented, but we observed no significant change in the slope of consumption. cascade reporting may be a useful strategy to optimize antimicrobial prescribing.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2021.83","type":"journal-article","created":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T08:03:28Z","timestamp":1617696208000},"page":"199-204","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":14,"title":["Impact of cascade reporting of antimicrobial susceptibility on fluoroquinolone and meropenem consumption at a Veterans\u2019 Affairs medical center"],"prefix":"10.1017","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7748-1215","authenticated-orcid":false,"given":"Nicole C.","family":"Vissichelli","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine M.","family":"Orndahl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane A.","family":"Cecil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily M.","family":"Hill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew M.","family":"Hitchcock","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roy T.","family":"Sabo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael P.","family":"Stevens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Tassone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leroy B.","family":"Vaughan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Daniel","family":"Markley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2021,4,6]]},"reference":[{"key":"S0899823X21000830_ref2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz027"},{"key":"S0899823X21000830_ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-016-2645-5"},{"key":"S0899823X21000830_ref5","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-11-187"},{"key":"S0899823X21000830_ref13","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing","author":"Weinstein","year":"2019"},{"key":"S0899823X21000830_ref21","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00950-16"},{"key":"S0899823X21000830_ref19","article-title":"Out of sight-out of mind: impact of cascade reporting on antimicrobial usage","author":"Liao","year":"2020","journal-title":"Open Forum Infect Dis"},{"key":"S0899823X21000830_ref14","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkr088"},{"key":"S0899823X21000830_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2017.01.040"},{"key":"S0899823X21000830_ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-014-2293-6"},{"key":"S0899823X21000830_ref15","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkg032"},{"key":"S0899823X21000830_ref4","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu542"},{"key":"S0899823X21000830_ref25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2005.01238.x"},{"key":"S0899823X21000830_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2016.11.014"},{"key":"S0899823X21000830_ref22","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp14X681373"},{"key":"S0899823X21000830_ref8","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.12432"},{"key":"S0899823X21000830_ref6","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy035"},{"key":"S0899823X21000830_ref11","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw118"},{"key":"S0899823X21000830_ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-012-1786-4"},{"key":"S0899823X21000830_ref1","unstructured":"1. Antibiotic resistance threats in the United States. Centers for Disease Control website. https:\/\/www.cdc.gov\/drugresistance\/pdf\/threats-report\/2019-ar-threats-report-508.pdf. Published 2019. Accessed March 4, 2021."},{"key":"S0899823X21000830_ref7","doi-asserted-by":"publisher","DOI":"10.7150\/ijms.8.339"},{"key":"S0899823X21000830_ref10","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkr156"},{"key":"S0899823X21000830_ref12","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2019.293"},{"key":"S0899823X21000830_ref23","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy075"},{"key":"S0899823X21000830_ref3","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy863"},{"key":"S0899823X21000830_ref24","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofy162"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X21000830","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T08:18:08Z","timestamp":1645172288000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X21000830\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,6]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["S0899823X21000830"],"URL":"https:\/\/doi.org\/10.1017\/ice.2021.83","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,6]]},"assertion":[{"value":"\u00a9 The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}