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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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