The Association Between the Frequency of Interruptions in Antibiotic Exposure and the Risk of Health Care-Associated Infection.

BACKGROUND

Although antibiotic use is an established risk factor for health care-associated infection, estimates of the association between infection and antibiotic use vary, depending upon how antibiotic exposure is measured.

OBJECTIVES

The purpose of this study was to explore the association between the frequency of interruptions in antibiotic exposure and the risk of health care-associated infection.

METHODS

A retrospective chart review cohort study was conducted of all inpatients between 2011and 2016 from a single academic health center who received at least 1 dose of a systemic antibacterial for a cumulative duration of >3 days and ≤30 days. The measures of antibiotic exposure examined were durationcumulative total calendar days of antibiotics therapy-and continuity-the frequency of interruptions in antibiotic exposure that was defined as the number of antibiotic treatment courses.

RESULTS

A total of 52,445/227,967 (23%) patients received antibacterial therapy for >3 days and ≤30 days during their hospitalization. Of these, 1161 out of 52,445 (2.21%) were patients with health care-associated infection. An adjusted multivariable logistic regression analysis revealed that the risk of increased with longer cumulative days (odds ratio = 2.7; comparison of >12 days to ≤5 days) and fewer interruptions of antibiotic treatment (odds ratio = 0.78; comparison of >3 discrete antibiotic treatment courses to 1 course or continuous antibiotic treatment course; all values < 0.05).

CONCLUSIONS

For patients who received the same number of cumulative days of therapy, the patients who had more frequently interrupted courses of antibiotic therapy were less likely to experience health care-associated infection. (. 2020; 81:XXX-XXX).