Journal of clinical and translational science · 2025
Guideline-concordant antibiotic prescribing for community-acquired bacterial pneumonia (CABP) due to drug-resistant pathogens in the All of Us database.
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Gilmore Corbyn M, Vargus Adriana, Lee Grace C, Schmidt Susanne, Reveles Kelly R, Alvarez Carlos A, Frei Christopher R
Аннотация
INTRODUCTION: Community-acquired bacterial pneumonia (CABP) contributes significantly to mortality and healthcare costs worldwide. The use of guideline-concordant antibiotic therapy for CABP is associated with improved outcomes.
METHODS: This was a retrospective cohort study of inpatients with CABP due to MRSA or P. aeruginosa in the All of Us database. The proportion of patients on guideline-concordant antibiotics or guideline-discordant antibiotics was compared within groups based upon patient age, sex, self-reported race, ethnicity, marital status, alcohol use, and tobacco use. Guideline concordance was determined using the 2019 IDSA/ATS CABP guidelines. Associations were further analyzed using multivariate logistic regression.
RESULTS: A total of 336 patients with CABP due to MRSA (152) or P. aeruginosa (184) were included. Guideline-concordant antibiotic therapy was prescribed to 70% of CABP-MRSA patients and for 57% of CABP-P. aeruginosa patients. Independently predictive factors of guideline-concordant antibiotic prescribing for CABP-P. aeruginosa patients were Non-Hispanic Black (NHB) vs. Non-Hispanic White (NHW) race (odds ratio = 0.30, 95% confidence interval = 0.12 - 0.75).
CONCLUSION: In the All of Us database, the majority of CABP-MRSA and CABP-P. aeruginosa patients were prescribed guideline-concordant antibiotic therapy. Race was independently predictive of guideline-concordant antibiotic therapy for patients with CABP-P. aeruginosa, but not CABP-MRSA. NHB patients were less likely to receive guideline-concordant antibiotic therapy than NHW patients when treated for CABP-P. aeruginosa.
METHODS: This was a retrospective cohort study of inpatients with CABP due to MRSA or P. aeruginosa in the All of Us database. The proportion of patients on guideline-concordant antibiotics or guideline-discordant antibiotics was compared within groups based upon patient age, sex, self-reported race, ethnicity, marital status, alcohol use, and tobacco use. Guideline concordance was determined using the 2019 IDSA/ATS CABP guidelines. Associations were further analyzed using multivariate logistic regression.
RESULTS: A total of 336 patients with CABP due to MRSA (152) or P. aeruginosa (184) were included. Guideline-concordant antibiotic therapy was prescribed to 70% of CABP-MRSA patients and for 57% of CABP-P. aeruginosa patients. Independently predictive factors of guideline-concordant antibiotic prescribing for CABP-P. aeruginosa patients were Non-Hispanic Black (NHB) vs. Non-Hispanic White (NHW) race (odds ratio = 0.30, 95% confidence interval = 0.12 - 0.75).
CONCLUSION: In the All of Us database, the majority of CABP-MRSA and CABP-P. aeruginosa patients were prescribed guideline-concordant antibiotic therapy. Race was independently predictive of guideline-concordant antibiotic therapy for patients with CABP-P. aeruginosa, but not CABP-MRSA. NHB patients were less likely to receive guideline-concordant antibiotic therapy than NHW patients when treated for CABP-P. aeruginosa.