Parallel analysis of individual and aggregated data on antibiotic exposure and resistance in gram-negative bacilli
Parallel analysis of individual and aggregated data on antibiotic exposure and resistance in gram-negative bacilli
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DOI：
10.1086/322677
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发表时间：
2001-11-01
影响因子：
11.8
通讯作者：
Samore, MH
中科院分区：
文献类型：
--
作者：
Harbarth, S;Harris, AD;Samore, MH
为了评估分析汇总数据的潜在偏倚，我们分别从个体患者角度和群体角度检查了犹他州一所大学医院35,423名患者的抗生素暴露和耐药性数据。从1994年到1998年，氟喹诺酮类药物、第三代头孢菌素、氨苄西林-沙巴坦和亚胺培南的限定日剂量（每1000病人日）的使用分别增加了82%、38%和99%，减少了38%，而肠杆菌科或假单胞菌种的组水平耐药率变化很小。然而，在通过多变量比例风险回归进行的个体患者水平分析中，暴露于氟喹诺酮类药物、第三代头孢菌素、氨苄西林-沙巴坦或亚胺培南是氟喹诺酮类药物耐药的一个很强的危险因素(校正风险比[AHR]， 4.0
To evaluate the potential bias of analyzing aggregated data, we separately examined antibiotic exposure and resistance data for 35,423 patients admitted to a university hospital in Utah, from both an individual-patient perspective and group-level perspective. From 1994 through 1998, use of defined daily doses (per 1000 patient-days) of fluoroquinolones, third-generation cephalosporins, ampicillin-sulbactam, and imipenem increased by 82%, 38%, and 99%, and decreased by 38%, respectively, whereas group-level resistance rates of Enterobacteriaceae or Pseudomonas species changed only minimally. However, in individual-patient-level analyses performed by multivariable proportional hazards regression, exposure to a fluoroquinolone, third-generation cephalosporin, ampicillin-sulbactam, or imipenem was a strong risk factor for resistance to fluoroquinolones (adjusted hazard ratio [AHR], 4.0; P