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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
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