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Table 5 Time to event-analyses for CLC residents received only one subtype of potentially suboptimal treatment (drug choice, dose frequency, or excessive treatment duration) as compared to optimal treatment

From: Poor clinical outcomes associated with suboptimal antibiotic treatment among older long-term care facility residents with urinary tract infection: a retrospective cohort study

Outcome

Subtype of potentially suboptimal treatment

Unadjusted HR

Lower 95% CI

Upper 95% CI

Adjusted HR

Lower 95% CI

Upper 95% CI

Poor clinical outcomea

Suboptimal drug choice

0.91

0.86

0.97

0.96

0.91

1.03

Suboptimal dose frequency

1.35

1.25

1.45

1.29

1.20

1.39

Longer than recommended treatment duration

0.92

0.83

1.03

0.90

0.81

1.01

Hospitalization/ Emergency department visitb

Suboptimal drug choice

0.87

0.80

0.94

0.95

0.87

1.04

Suboptimal dose frequency

1.19

1.07

1.31

1.13

1.02

1.26

Longer than recommended treatment duration

1.08

0.94

1.25

1.03

0.89

1.18

UTI recurrencec

Suboptimal drug choice

0.86

0.78

0.95

0.93

0.84

1.04

Suboptimal dose frequency

1.14

1.01

1.30

1.13

0.99

1.28

Longer than recommended treatment duration

0.88

0.73

1.06

0.85

0.70

1.02

All-cause mortalityd

Suboptimal drug choice

1.00

0.89

1.12

0.93

0.82

1.04

Suboptimal dose frequency

1.52

1.33

1.73

1.44

1.26

1.65

Longer than recommended treatment duration

0.68

0.53

0.86

0.71

0.55

0.90

Clostridioides difficile infectione

Suboptimal drug choice

0.92

0.67

1.25

1.04

0.75

1.45

Suboptimal dose frequency

3.51

2.66

4.63

3.21

2.42

4.25

Longer than recommended treatment duration

1.64

1.05

2.58

1.37

0.87

2.15

Antibiotic related adverse drug eventf

Suboptimal drug choice

0.58

0.25

1.35

0.68

0.29

1.59

Suboptimal dose frequency

1.50

0.65

3.48

1.38

0.59

3.20

Longer than recommended treatment duration

1.21

0.35

4.12

1.20

0.35

4.11

  1. CI Confidence interval, CLC Community Living Center, HR Hazard ratio, UTI Urinary tract infection, VAMC Veterans Affairs Medical Center
  2. aAdjusted for 8 resident-level covariates (genitourinary disease comorbidity, cardiopulmonary comorbidity, chronic renal disease comorbidity, previous fluroquinolone exposure in the past 30 days, age, previous VAMC hospitalization in the past 30 days, previous VAMC urine culture in the past 365 days, high white blood cell count), and 1 CLC-level covariate (total CLC incident UTI rate per 10,000 bed days)
  3. bAdjusted for 10 resident-level covariates (cardiopulmonary comorbidity, genitourinary disease comorbidity, chronic renal disease comorbidity, age, previous VAMC hospitalization in the past 30 days, previous outpatient VA urine culture in the past 365 days, previous CLC urine culture in the past 365 days, previous VAMC urine culture in the past 365 days, high white blood cell count, year of episode) and 1 CLC-level covariate (total CLC incident UTI rate per 10,000 bed days)
  4. cAdjusted for 5 resident-level covariates (genitourinary disease comorbidity, previous fluroquinolone exposure in the past 30 days, previous fluroquinolone resistant culture in the past 365 days, previous CLC urine culture in the past 365 days, previous VAMC urine culture in the past 365 days), and 1 CLC-level covariate (total CLC incident UTI rate per 10,000 bed days)
  5. dAdjusted for 10 resident-level covariates (history of a skin infection diagnosis in the past 365 days, history of a urinary tract infection diagnosis in the past 365 days, chronic renal disease comorbidity, age, previous fluroquinolone exposure in the past 30 days, previous VAMC hospitalization in the past 30 days, previous outpatient VA urine culture in the past 365 days, previous VAMC urine culture in the past 365 days, high white blood cell count, year of episode), and 1 CLC-level covariate (total CLC incident UTI rate per 10,000 bed days)
  6. e Adjusted for 8 resident-level covariates (history of a skin infection diagnosis in the past 365 days, genitourinary disease comorbidity, chronic renal disease comorbidity, previous VAMC hospitalization in the past 30 days, previous CLC urine culture in the past 365 days, previous VAMC urine culture in the past 365 days, high white blood cell count, year of episode), and 1 CLC-level covariate (total CLC incident UTI rate per 10,000 bed days)
  7. fAdjusted for 2 resident-level covariates (VAMC hospitalization in the past 30 days, year of episode), and 1 CLC-level covariate (total CLC incident UTI rate per 10,000 bed days)
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BMC Geriatrics

ISSN: 1471-2318

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