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Table 5 Multivariate associationsa between patient (P), department (D) and hospital (H) characteristics and QI performance scores, and explained variance.

From: Appropriate antibiotic use for patients with complicated urinary tract infections in 38 Dutch Hospital Departments: a retrospective study of variation and determinants

QI

 

Odds ratio (95 % CI)

P

1

Perform a urine culture

  

P

Febrile UTI

1.98 (1.49-2.63)

<0.001

D

Residents working at department

3.38 (1.60-7.14)

0.001

 

Explained variance (%)

12.6

 

2A

Prescribe empirical therapy according to national guideline

  

P

Admission at night

0.61 (0.43-0.86)

0.007

P

Urinary catheter

0.15 (0.10-0.22)

<0.001

H

Presence of infectious diseases (ID) physician

2.52 (1.27-5.01)

0.008

H

Antibiotic formulary

2.98 (1.33-6.67)

0.008

 

Explained variance (%)

19.4

 

2B

Prescribe empirical therapy according to local guideline

  

P

Febrile UTI

1.75 (1.23-2.49)

0.002

P

Antibiotic therapy within past 14 days

0.68 (0.52-0.90)

0.007

P

Urinary catheter

0.47 (0.31-0.71)

<0.001

D

Structural education on antibiotics for senior staff members

10.39 (2.83-38.15)

<0.001

 

Explained variance (%)

23.7

 

3

Switch from iv to oral therapy within 72 hours on the basis of the clinical condition

  

P

Older age

0.85 (0.75-0.95)b

0.005

D

Feedback on antibiotic prescription at the department level

0.25 (0.10-0.59)

0.002

D

Higher proportion female physicians

0.70 (0.55-0.90)c

0.005

 

Explained variance (%)

26.5

 

4

Tailor antibiotic treatment on the basis of culture results

  

D

Feedback regarding pathogen-directed therapy on the basis of blood or urine culture result

0.23 (0.11-0.48)

<0.001

Explained variance (%)

11.1

 

6A

Duration of antibiotic therapy should be at least 10 days

  

P

Febrile UTI

2.22 (1.62-3.05)

<0.001

P

Female patient

0.44 (0.33-0.58)

<0.001

 

Explained variance (%)

12.3

 

6B

Duration of antibiotic therapy should be according to local guideline

  

P

Female patient

0.59 (0.44-0.80)

<0.001

 

Explained variance (%)

15.7

 

7A

Treat UTI in men according to national guideline

  

P

Febrile UTI

2.33 (1.60-3.40)

<0.001

D

Quality improvement project in past 3 years

0.46 (0.27-0.77)

0.004

D

Feedback on antibiotic resistance rates of the hospital

2.07 (1.19-3.61)

0.01

 

Explained variance (%)

17.6

 

7B

Treat UTI in men according to local guideline

  

D

Quality improvement project in past 3 years

0.29 (0.13-0.65)

0.003

Explained variance (%)

17.1

  1. aData are presented as Odds Ratios (95 % confidence interval); an Odds Ratio > 1 means a positive association with the QI and an Odds Ratio < 1 means a negative association.
  2. bOR per 10 years increase in age (per 1 year increase in age: OR 0.98; 95 % CI: 0.97-1.00).
  3. cOR per 10 % increase in proportion female physicians (per % increase: OR 0.97; 95 % CI: 0.94-0.99).
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BMC Infectious Diseases

ISSN: 1471-2334

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