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Table 4 Factors associated with non-adherence to antibiotic guideline

From: Identifying targets for antibiotic stewardship interventions through analysis of the antibiotic prescribing process in hospitals - a multicentre observational cohort study

 

Adherence (n = 778) n (%)

Non-adherence (n = 457) n (%)

Univariate analysis OR (95% CI)

p-value

Adjusted analysisaOR (95% CI)

p-value

AB initiated

 Emergency room

670 (64.9)

363 (35.1)

1

 

1

 

 Ward

108 (53.5)

94 (46.5)

1.6 (1.18, 2.18)

0.002

1.7 (1.24, 2.36)

0.001

Indication for treatment

 LRTI

280 (68.0)

132 (32.0)

1

 

1

 

 COPD ex

177 (63.2)

103 (36.8)

1.23 (0.90, 1.70)

0.196

1.42 (1.03, 1.98)

0.035

 Sepsis

151 (60.9)

97 (39.1)

1.36 (0.98, 1.89)

0.065

1.44 (1.02, 2.02)

0.037

 SSTI

90 (60.0)

60 (40.0)

1.41 (0.96, 2.10)

0.079

1.56 (1.05, 2.31)

0.028

 UTI

80 (55.2)

65 (44.8)

1.72 (1.17, 2.54)

0.006

1.62 (1.09, 2.41)

0.017

Hospital

 Hospital A

376 (60.8)

242 (39.2)

1

 

1

 

 Hospital B

203 (70.7)

84 (29.3)

0.64 (0.48, 0.87)

0.004

0.63 (0.46, 0.86)

0.004

 Hospital C

199 (60.3)

131 (39.7)

1.02 (0.78, 1.34)

0.872

0.95 (0.71, 1.26)

0.712

Admitted from institution

  No

678 (64.3)

377 (35.7)

1

   

  Yes

100 (55.6)

80 (44.4)

1.44 (1.04, 1.98)

0.026

1.44 (1.04, 2.00)

0.029

Accuracy between indication for AB-treatment and discharge infection diagnosesb

 Yes

604 (63.3)

350 (36.7)

1

 

1

 

 No

174 (61.9)

107 (38.1)

1.06 (0.81, 1.40)

0.671

0.99 (0.72, 1.35)

0.936

Sex

 Male

411 (62.7)

245 (37.3)

1

 

1

 

 Female

367 (63.4)

212 (36.6)

0.97 (0.77. 1.22)

0.790

0.98 (0.77, 1.24)

0.857

Age

  < 45

106 (64.6)

58 (35.4)

1

 

1

 

 46–65

168 (60.7)

109 (39.3)

1.19 (0.79, 1.77)

0.405

1.26 (0.83, 1.91)

0.277

 66–85

367 (62.7)

218 (37.3)

1.09 (0.76, 1.56)

0.656

1.08 (0.73, 1.60)

0.695

  > 85

137 (65.6)

72 (34.4)

0.96 (0.63, 1.47)

0.854

0.87 (0.54, 1.37)

0.540

Charlson Comorbidity Index

 CCI = 0

304 (65.8)

158 (34.2)

1

 

1

 

 CCI = 1

265 (63.1)

155 (36.9)

1.13 (0.85, 1.48)

0.402

1.14 (0.83, 1.56)

0.421

 CCI = 2

102 (57.9)

74 (42.1)

1.40 (0.98, 1.99)

0.066

1.35 (0.93, 1.97)

0.115

 CCI = 3

48 (60.8)

31 (39.2)

1.24 (0.76, 2.10)

0.386

1.20 (0.72, 2.02)

0.482

 CCI = 4

26 (61.9)

16 (38.1)

1.18 (0.62, 2.27)

0.611

1.18 (0.60, 2.33)

0.626

 CCI > 4

33 (58.9)

23 (41.1)

1.34 (0.76, 2.36)

0.310

1.39 (0.77, 2.51)

0.279

Number of working diagnoses

 1

493 (64.6)

270 (35.4)

1

 

1

 

 2

238 (60.7)

154 (39.3)

1.18 (0.92, 1.52)

0.193

1.12 (0.87, 1.46)

0.381

 3

47 (58.8)

33 (41.2)

1.28 (0.80, 2.05)

0.299

1.18 (0.73, 1.92)

0.491

Antibiotic allergiesc

 No

708 (63.7)

403 (36.3)

1

 

1

 

 Yes

69 (56.6)

53 (43.4)

1.35 (0.92, 1.97)

0.120

1.40 (0.95, 2.06)

0.088

eGFR

 eGFR > 50

598 (62.6)

357 (37.4)

1

 

1

 

 eGFR < 50

180 (64.3)

100 (35.7)

0.93 (0.71, 1.23)

0.611

0.88 (0.66, 1.17)

0.378

  1. a All factors are adjusted for where AB was initiated, indication for AB treatment, hospital and admittance from institution
  2. b Measured as match between initial grouped indication for treatment and grouped discharge diagnosis
  3. c1 data missing