Table 3 Comparison of patient variables in guideline adherent vs. non-adherent antibiotic therapy
Empirical antibiotic treatment | Treatment duration | |||||||
|---|---|---|---|---|---|---|---|---|
Na | Guideline-adherent therapy | Non-adherent therapy | p-valueb | Na | Guideline-adherent therapy | Non-adherent therapy | p-valueb | |
479 | (N = 382) | (N = 97) | 341 | (N = 69) | (N = 272) | |||
Demographic characteristics | ||||||||
Gender (male), n (%) | 479 | 222 (58%) | 49 (51%) | 0.177 | 341 | 33 (48%) | 148 (54%) | 0.328 |
Age (years), median (IQR) | 479 | 74 (63, 81) | 73 (65, 79) | 0.876 | 341 | 70 (55, 78) | 71 (61, 78) | 0.485 |
Dependency and comorbidity at admission | ||||||||
Charlson Comorbidity Index | 479 | 4 (3, 5) | 4 (2, 5) | 0.324 | 341 | 4 (1, 5) | 4(2, 5) | 0.888 |
Dependent on care on admission, n (%) | 478 | 82 (21%) | 28 (29%) | 0.109 | 341 | 17 (25%) | 43 (16%) | 0.085 |
Clinical Frailty Scale > 4, n (%) | 478 | 46 (12%) | 20 (21%) | 0.029* | 9 (13%) | 23 (8.5%) | 0.243 | |
Hypertension, n (%) | 479 | 131 (34%) | 45 (46%) | 0.027* | 341 | 25 (36%) | 93 (34%) | 0.750 |
Congestive heart failure, n (%) | 479 | 56 (15%) | 21 (22%) | 0.094 | 341 | 11 (16%) | 35 (13%) | 0.504 |
Diabetes mellitus, n (%) | 479 | 45 (12%) | 17 (18%) | 0.260 | 341 | 9 (13%) | 33 (12%) | 0.837 |
Chronic kidney disease, n (%) | 479 | 30 (7.9%) | 15 (15%) | 0.022* | 341 | 4 (5.8%) | 18 (6.6%) | >0.999 |
Cancer, n (%) | 479 | 35 (9.2%) | 11 (11%) | 0.516 | 341 | 4 (5.8%) | 19 (7.0%) | >0.999 |
Immunodeficiency, n (%) | 479 | 36 (9.4%) | 11 (11%) | 0.571 | 341 | 4 (5.8%) | 30 (11%) | 0.195 |
COPD, n (%) | 479 | 160 (42%) | 37 (38%) | 0.504 | 341 | 27 (39%) | 107 (39%) | 0.975 |
Cognitive impairment, n (%) | 479 | 10 (2.6%) | 5 (5.2%) | 0.199 | 341 | 2 (2.9%) | 5 (1.8%) | 0.633 |
Antibiotic allergy, any, n (%) | 479 | 24 (6.3%) | 22 (23%) | <0.001* | 341 | 11 (16%) | 31 (11%) | 0.305 |
Pre-admission vaccines and exposure | ||||||||
Pneumococcal vaccine last 5 years, n (%) | 479 | 151 (40%) | 48 (49%) | 0.076 | 341 | 27 (39%) | 113 (42%) | 0.716 |
Influenza vaccination, current season, n (%) | 479 | 214 (56%) | 55 (57%) | 0.904 | 341 | 29 (42%) | 160 (59%) | 0.012* |
Unvaccinated SARS-CoV2, n (%) | 466 | 96 (25%) | 27 (28%) | 0.586 | 333 | 21 (30%) | 45 (17%) | 0.015* |
Severity scores at admission | ||||||||
NEWS2 score > 4, n (%) | 476 | 208 (55%) | 56 (58%) | 0.625 | 339 | 34 (49%) | 131 (49%) | 0.955 |
PSI score > 90, n (%) | 430 | 161 (47%) | 50 (57%) | 0.091 | 296 | 25 (41%) | 96 (41%) | 0.803 |
CRB-65 score > 2, n (%) | 479 | 3 (0.8%) | 11 (11%) | <0.001* | 341 | 3 (4.3%) | 4 (1.5%) | 0.150 |
SOFA score ≥ 2 first 24 h of admission, n (%) | 434 | 245 (71%) | 70 (80%) | 0.353 | 303 | 35 (54%) | 156 (66%) | 0.117 |
Antibiotics at admission | ||||||||
Initiated before admission/Ongoing, n (%) | 479 | 77 (20%) | 30 (31%) | 0.023* | 241 | 18 (26%) | 57 (21%) | 0.358 |
Immunosuppressive medications on admission | ||||||||
Corticosteroids, n (%) | 479 | 55 (14%) | 18 (19%) | 0.309 | 341 | 7 (10%) | 37 (14%) | 0.226 |
Other immunomodulants, n (%) | 479 | 37 (9.7%) | 8 (8.2%) | 0.665 | 341 | 7 (10%) | 20 (7.4%) | 0.569 |
Microbial detections during admission | ||||||||
Clinically relevant bacteria detected, n (%) | NA | 341 | 23 (33%) | 149 (55%) | 0.001* | |||
Clinically relevant virus detected, n (%) | NA | 341 | 38 (55%) | 112 (41%) | 0.038* | |||
Gram positive detectionc, n (%) | NA | 341 | 17 (25%) | 62 (23%) | 0.746 | |||
H. influenzae and/or M. catarrhalis detected, n (%) | NA | 341 | 13 (19%) | 102 (38%) | 0.003* | |||
Enterobacterales or non-fermenters detected, n (%) | NA | 341 | 2 (2.9%) | 37 (14%) | 0.013* | |||
Dependancy at discharge | ||||||||
Independent, n (%) | NA | 340 | 46 (67%) | 218 (80%) | 0.017* | |||
Discharged to nursing home or other health care institution, n (%) | NA | 340 | 5 (7.2%) | 12 (4.4%) | 0.353 | |||
Outcomes | ||||||||
Length of stay (days), median (IQR) | NA | 341 | 2.09 (1.04, 3.50) | 3.06 (2.07, 4.05) | <0.001* | |||
Readmission within 30 days of discharge, n (%) | NA | 341 | 15 (22%) | 31 (11%) | 0.025* | |||
Mortality within 30 days of admission, n (%) | NA | 341 | 0 (0%) | 3 (1.1%) | >0.999 | |||