title: Use of data envelopment analysis to quantify opportunities for antibacterial targets for reduction of health care-associated Clostridium difficile infection.
abstract: Clostridium difficile infection (CDI) is an important health care-associated infection that leads to increased morbidity and mortality. Antibacterial medications used in hospitals serve as targets for antibacterial stewardship programs to reduce C difficile. The objective was to create a benchmark strategy targeting high-risk antibacterials for C difficile. This was a retrospective cross-sectional study using claims data from 58 hospitals. The Data Envelopment Analysis Technique was used to identify best-practice hospitals in terms of less use of 5 classes of antibacterials and fewer CDIs. Of 58 hospitals, 17 (29%) were identified as best-practice hospitals. Antibacterial classes requiring the greatest percentage reduction in use in non-best-practice hospitals versus best-practice hospitals were clindamycin (31%), β-lactam/β-lactamase combinations (30%), and carbapenems (29%). This study suggests that there are areas of improvement in high-risk antibacterial use that could lead to decreased CDIs.
authors.affiliation: School of Pharmacy, Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University apakyz@vcu.edu.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Pakyz
authors.affiliation: School of Allied Health Professions, Department of Health Administration, Virginia Commonwealth University.
authors.forename: Yasar A
authors.initials: YA
authors.lastname: Ozcan
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D019985:Benchmarking; D016360:Clostridioides difficile; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology / Q000517:prevention & control*; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents
keywords: Clostridium difficile; antibacterials; benchmarking; health care infections