{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T03:03:32Z","timestamp":1778900612680,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T00:00:00Z","timestamp":1666051200000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Current methods for benchmarking inpatient antimicrobial use (AU) could benefit from combining AU with antimicrobial resistance (AR) information to provide metrics benchmarked to microbiological data; this may yield more instructive and better risk\u2010adjusted measurements than AU and AR in isolation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective single\u2010center study, we computed facility\u2010wide AU\/AR ratios from 2019 to 2020 for specific antimicrobial agents and corresponding AR events, and compared median monthly AU\/AR ratios between March 2019 through December 2019 (pre\u2010COVID period) and March 2020 through December 2020 (COVID period). Aggregate AU was expressed as a ratio to aggregate AR events for antimicrobials that typically have activity against the AR organism and are frequently used to treat the AR organism in clinical practice. We also computed AU\/AR ratios in our surgical intensive care unit in the pre\u2010COVID period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>High\u2010median facility\u2010wide monthly AU\/AR ratios were observed for intravenous vancomycin\/methicillin\u2010resistant <jats:italic>Staphylococcus aureus<\/jats:italic>, with 130.0 in the pre\u2010COVID period and 121.3 in the COVID period (<jats:italic>p<\/jats:italic> =.520). Decreases in facility\u2010wide median monthly AU\/AR ratios were observed between periods for meropenem\/ESBL Enterobacterales (20.9 vs. 7.9, <jats:italic>p<\/jats:italic> &lt; .001), linezolid\/vancomycin\u2010resistant <jats:italic>Enterococcus<\/jats:italic> (48.5 vs. 15.8, <jats:italic>p<\/jats:italic> =.004), and daptomycin\/vancomycin\u2010resistant <jats:italic>Enterococcus<\/jats:italic> (32.2 vs. 4.8, <jats:italic>p<\/jats:italic> = .002). Increases in facility\u2010wide median monthly AU\/AR ratios were observed between periods for ceftazidime\u2010avibactam\/carbapenem\u2010resistant Enterobacterales (0.0 vs. 3.2, <jats:italic>p<\/jats:italic> = .020) and ceftazidime\u2010avibactam\/multidrug\u2010resistant <jats:italic>Pseudomonas aeruginosa<\/jats:italic> (0.0 vs. 4.0, <jats:italic>p<\/jats:italic> = .017). The AU\/AR ratio for intravenous vancomycin\/methicillin\u2010resistant <jats:italic>S. aureus<\/jats:italic> in the surgical intensive care unit was 191.5 in the pre\u2010COVID period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>AU\/AR ratios may be used to supplement current AU and AR metrics. Future directions should include the development of more AU metrics benchmarked to microbiological information. AU metrics more specific to transplant infectious diseases should be developed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13924","type":"journal-article","created":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T07:04:42Z","timestamp":1666076682000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Computing antimicrobial use\/antimicrobial resistance ratios: A novel way to assess inpatient antimicrobial utilization using current National Healthcare Safety Network metrics"],"prefix":"10.1111","volume":"24","author":[{"given":"Carlos A. Q.","family":"Santos","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases Department of Internal Medicine Rush University Medical Center  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley I.","family":"Martinez","sequence":"additional","affiliation":[{"name":"Rush Alzheimer's Disease Center Rush University Medical Center  Chicago Illinois USA"},{"name":"Division of Therapeutics and Infectious Disease Epidemiology, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah Y.","family":"Won","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Internal Medicine Rush University Medical Center  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6224-0371","authenticated-orcid":false,"given":"Christy A.","family":"Varughese","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Rush University Medical Center  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marion","family":"Tseng","sequence":"additional","affiliation":[{"name":"Medical Research Analytics and Informatics Alliance  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiyuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Health Research and Solutions, Cook County Health  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William E.","family":"Trick","sequence":"additional","affiliation":[{"name":"Health Research and Solutions, Cook County Health  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,10,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(14)70780-7"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16743"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2013.091769"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.23374"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq494"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1086\/510393"},{"issue":"9","key":"e_1_2_9_8_1","first-page":"194","article-title":"Vital signs: Improving antibiotic use among hospitalized patients","volume":"63","author":"Fridkin S","year":"2014","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_9_9_1","unstructured":"Antimicrobial Use and Resistance (AUR) Module.cdc.gov\/nhsn\/pdfs\/pscmanual\/11pscaurcurrent.pdf. 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