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. 2022 Dec 13;11(12):1807.
doi: 10.3390/antibiotics11121807.

Association between Carbapenem Consumption and Clinical Outcomes in an In-Hospital Setting: Analysis of a Japanese Nationwide Administrative Database in 2020

Kozue Yamaguchi  1 , Masayuki Maeda  1 , Norio Ohmagari  2 , Yuichi Muraki  3
Affiliations

Association between Carbapenem Consumption and Clinical Outcomes in an In-Hospital Setting: Analysis of a Japanese Nationwide Administrative Database in 2020

Kozue Yamaguchi et al. Antibiotics (Basel). .

Abstract

This study aimed to clarify the relationship between carbapenem consumption and clinical outcome using the diagnosis procedure combination (DPC) payment system database (2020) published by the Ministry of Health, Labour, and Welfare of Japan. This study divided 5316 medical facilities subject to aggregation into five facilities and calculated the median values, including facility characteristics, clinical outcomes, and carbapenem consumption. Next, a correlation analysis was performed between carbapenem consumption and clinical outcome, as well as a multiple regression analysis between carbapenem consumption as the dependent variable and clinical outcome, bed size, and proportion of patients by disease as independent variables. Additionally, three clinical outcomes available from the DPC payment system database were selected, including cure, readmission within 4 weeks, and the average length of stay. This study revealed no relationship between carbapenem consumption and clinical outcome in university hospitals and university hospital-equivalent community hospitals; however, a relationship was suggested in the community, DPC-prepared, and non-DPC hospitals. University hospitals and university hospital-equivalent community hospitals with a high consumption of carbapenems may need to reconsider the classification because of the limited number of facilities in this classification.

Keywords: antimicrobial consumption; carbapenem consumption clinical outcomes; defined daily dose; diagnosis procedure combination data analysis.

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Conflict of interest statement

The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Study flow diagram showing the stratification and selection of patients in the Diagnosis Procedure Combination database by the Ministry of Health and Welfare in the fiscal year 2020.
Figure 2
Figure 2
Median carbapenem consumption stratified by facility type. The outliners were plotted on the box plot as a small circle and a star.
See this image and copyright information in PMC

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