Results of Segmented Negative Binomial Regression Analyses for Sensitivity Data
| Outcome . | Variable . | IRR . | (95% CI) . | P Value . |
|---|---|---|---|---|
| Broad-spectrum agents predominantly used for hospital-onset/MDR bacteria | ||||
| Baseline level | 6.264 | (4.265–9.200) | < .0001 | |
| Trend preimplementation | 0.993 | (.986–1.000) | .0649 | |
| Change in level at implementation | 1.807 | (1.681–1.940) | < .0001 | |
| Trend postimplementation | 0.996 | (.992–.999) | .0068 | |
| Change in trend postimplementation | 1.002 | (.994–1.010) | .5779 | |
| Case mix index | 1.665 | (1.368–2.026) | < .0001 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.070 | (1.044–1.096) | < .0001 | |
| March–May | 1.014 | (.987–1.043) | .3142 | |
| June–August | 0.960 | (.929–.991) | .0120 | |
| Anti-MRSA agents | ||||
| Baseline level | 4.243 | (2.889–6.229) | < .0001 | |
| Trend preimplementation | 1.000 | (.992–1.008) | .9861 | |
| Change in level at implementation | 1.647 | (1.495–1.814) | < .0001 | |
| Trend postimplementation | 0.993 | (.989–.996) | .0001 | |
| Change in trend postimplementation | 0.993 | (.984–1.002) | .1184 | |
| Case mix index | 1.643 | (1.348–2.002) | < .0001 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.079 | (1.046–1.113) | < .0001 | |
| March–May | 1.043 | (1.010–1.077) | .0098 | |
| June–August | 0.963 | (.928–.999) | .0442 | |
| Broad spectrum agents predominantly used for community-acquired infection | ||||
| Baseline level | 2.635 | (1.780–3.900) | < .0001 | |
| Trend preimplementation | 1.001 | (.992–1.010) | .8777 | |
| Change in level at implementation | 2.433 | (2.199–2.692) | < .0001 | |
| Trend postimplementation | 0.991 | (.988–.995) | < .0001 | |
| Change in trend postimplementation | 0.991 | (.981–1.000) | .0653 | |
| Case mix index | 1.417 | (1.143–1.757) | .0015 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.087 | (1.050–1.126) | < .0001 | |
| March–May | 1.059 | (1.019–1.101) | .0038 | |
| June–August | 0.964 | (.929–.999) | .0450 | |
| Agents predominantly used for surgical site infection prophylaxisa | ||||
| Baseline level | 0.006 | (.001–.029) | < .0001 | |
| Trend preimplementation | 1.024 | (.993–1.056) | .1273 | |
| Change in level at implementation | 2.835 | (2.070–3.883) | < .0001 | |
| Trend postimplementation | 0.991 | (.988–.995) | < .0001 | |
| Change in trend postimplementation | 0.986 | (.955–1.019) | .4028 | |
| Case mix index | 7.032 | (3.007–16.444) | < .0001 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.219 | (1.055–1.408) | .0071 | |
| March–May | 1.011 | (.883–1.157) | .8786 | |
| June–August | 0.937 | (.800–1.098) | .4210 | |
| Overall (composite of all antibiotic groupings) | ||||
| Baseline level | 13.072 | (9.192–18.589) | < .0001 | |
| Trend preimplementation | 0.997 | (.999–1.004) | .4009 | |
| Change in level at implementation | 1.889 | (1.753–2.035) | < .0001 | |
| Trend postimplementation | 0.994 | (.991–.997) | < .0001 | |
| Change in trend postimplementation | 0.997 | (.989–1.004) | .4231 | |
| Case mix index | 1.642 | (1.367–1.972) | < .0001 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.076 | (1.050–1.102) | < .0001 | |
| March–May | 1.031 | (1.006–1.057) | .0137 | |
| June–August | 0.962 | (.935–.990) | .0080 |
| Outcome . | Variable . | IRR . | (95% CI) . | P Value . |
|---|---|---|---|---|
| Broad-spectrum agents predominantly used for hospital-onset/MDR bacteria | ||||
| Baseline level | 6.264 | (4.265–9.200) | < .0001 | |
| Trend preimplementation | 0.993 | (.986–1.000) | .0649 | |
| Change in level at implementation | 1.807 | (1.681–1.940) | < .0001 | |
| Trend postimplementation | 0.996 | (.992–.999) | .0068 | |
| Change in trend postimplementation | 1.002 | (.994–1.010) | .5779 | |
| Case mix index | 1.665 | (1.368–2.026) | < .0001 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.070 | (1.044–1.096) | < .0001 | |
| March–May | 1.014 | (.987–1.043) | .3142 | |
| June–August | 0.960 | (.929–.991) | .0120 | |
| Anti-MRSA agents | ||||
| Baseline level | 4.243 | (2.889–6.229) | < .0001 | |
| Trend preimplementation | 1.000 | (.992–1.008) | .9861 | |
| Change in level at implementation | 1.647 | (1.495–1.814) | < .0001 | |
| Trend postimplementation | 0.993 | (.989–.996) | .0001 | |
| Change in trend postimplementation | 0.993 | (.984–1.002) | .1184 | |
| Case mix index | 1.643 | (1.348–2.002) | < .0001 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.079 | (1.046–1.113) | < .0001 | |
| March–May | 1.043 | (1.010–1.077) | .0098 | |
| June–August | 0.963 | (.928–.999) | .0442 | |
| Broad spectrum agents predominantly used for community-acquired infection | ||||
| Baseline level | 2.635 | (1.780–3.900) | < .0001 | |
| Trend preimplementation | 1.001 | (.992–1.010) | .8777 | |
| Change in level at implementation | 2.433 | (2.199–2.692) | < .0001 | |
| Trend postimplementation | 0.991 | (.988–.995) | < .0001 | |
| Change in trend postimplementation | 0.991 | (.981–1.000) | .0653 | |
| Case mix index | 1.417 | (1.143–1.757) | .0015 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.087 | (1.050–1.126) | < .0001 | |
| March–May | 1.059 | (1.019–1.101) | .0038 | |
| June–August | 0.964 | (.929–.999) | .0450 | |
| Agents predominantly used for surgical site infection prophylaxisa | ||||
| Baseline level | 0.006 | (.001–.029) | < .0001 | |
| Trend preimplementation | 1.024 | (.993–1.056) | .1273 | |
| Change in level at implementation | 2.835 | (2.070–3.883) | < .0001 | |
| Trend postimplementation | 0.991 | (.988–.995) | < .0001 | |
| Change in trend postimplementation | 0.986 | (.955–1.019) | .4028 | |
| Case mix index | 7.032 | (3.007–16.444) | < .0001 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.219 | (1.055–1.408) | .0071 | |
| March–May | 1.011 | (.883–1.157) | .8786 | |
| June–August | 0.937 | (.800–1.098) | .4210 | |
| Overall (composite of all antibiotic groupings) | ||||
| Baseline level | 13.072 | (9.192–18.589) | < .0001 | |
| Trend preimplementation | 0.997 | (.999–1.004) | .4009 | |
| Change in level at implementation | 1.889 | (1.753–2.035) | < .0001 | |
| Trend postimplementation | 0.994 | (.991–.997) | < .0001 | |
| Change in trend postimplementation | 0.997 | (.989–1.004) | .4231 | |
| Case mix index | 1.642 | (1.367–1.972) | < .0001 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.076 | (1.050–1.102) | < .0001 | |
| March–May | 1.031 | (1.006–1.057) | .0137 | |
| June–August | 0.962 | (.935–.990) | .0080 |
The outcome Clostridioides difficile infection was not studied due to low occurrence.
Abbreviations: CI, confidence interval; IRR, incidence rate ratio; MDR, multidrug-resistant; MRSA, methicillin-resistant Staphylococcus aureus.
aRandom effect on change in slope omitted and residuals assumed to be independent and uncorrelated to obtain convergence.
Results of Segmented Negative Binomial Regression Analyses for Sensitivity Data
| Outcome . | Variable . | IRR . | (95% CI) . | P Value . |
|---|---|---|---|---|
| Broad-spectrum agents predominantly used for hospital-onset/MDR bacteria | ||||
| Baseline level | 6.264 | (4.265–9.200) | < .0001 | |
| Trend preimplementation | 0.993 | (.986–1.000) | .0649 | |
| Change in level at implementation | 1.807 | (1.681–1.940) | < .0001 | |
| Trend postimplementation | 0.996 | (.992–.999) | .0068 | |
| Change in trend postimplementation | 1.002 | (.994–1.010) | .5779 | |
| Case mix index | 1.665 | (1.368–2.026) | < .0001 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.070 | (1.044–1.096) | < .0001 | |
| March–May | 1.014 | (.987–1.043) | .3142 | |
| June–August | 0.960 | (.929–.991) | .0120 | |
| Anti-MRSA agents | ||||
| Baseline level | 4.243 | (2.889–6.229) | < .0001 | |
| Trend preimplementation | 1.000 | (.992–1.008) | .9861 | |
| Change in level at implementation | 1.647 | (1.495–1.814) | < .0001 | |
| Trend postimplementation | 0.993 | (.989–.996) | .0001 | |
| Change in trend postimplementation | 0.993 | (.984–1.002) | .1184 | |
| Case mix index | 1.643 | (1.348–2.002) | < .0001 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.079 | (1.046–1.113) | < .0001 | |
| March–May | 1.043 | (1.010–1.077) | .0098 | |
| June–August | 0.963 | (.928–.999) | .0442 | |
| Broad spectrum agents predominantly used for community-acquired infection | ||||
| Baseline level | 2.635 | (1.780–3.900) | < .0001 | |
| Trend preimplementation | 1.001 | (.992–1.010) | .8777 | |
| Change in level at implementation | 2.433 | (2.199–2.692) | < .0001 | |
| Trend postimplementation | 0.991 | (.988–.995) | < .0001 | |
| Change in trend postimplementation | 0.991 | (.981–1.000) | .0653 | |
| Case mix index | 1.417 | (1.143–1.757) | .0015 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.087 | (1.050–1.126) | < .0001 | |
| March–May | 1.059 | (1.019–1.101) | .0038 | |
| June–August | 0.964 | (.929–.999) | .0450 | |
| Agents predominantly used for surgical site infection prophylaxisa | ||||
| Baseline level | 0.006 | (.001–.029) | < .0001 | |
| Trend preimplementation | 1.024 | (.993–1.056) | .1273 | |
| Change in level at implementation | 2.835 | (2.070–3.883) | < .0001 | |
| Trend postimplementation | 0.991 | (.988–.995) | < .0001 | |
| Change in trend postimplementation | 0.986 | (.955–1.019) | .4028 | |
| Case mix index | 7.032 | (3.007–16.444) | < .0001 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.219 | (1.055–1.408) | .0071 | |
| March–May | 1.011 | (.883–1.157) | .8786 | |
| June–August | 0.937 | (.800–1.098) | .4210 | |
| Overall (composite of all antibiotic groupings) | ||||
| Baseline level | 13.072 | (9.192–18.589) | < .0001 | |
| Trend preimplementation | 0.997 | (.999–1.004) | .4009 | |
| Change in level at implementation | 1.889 | (1.753–2.035) | < .0001 | |
| Trend postimplementation | 0.994 | (.991–.997) | < .0001 | |
| Change in trend postimplementation | 0.997 | (.989–1.004) | .4231 | |
| Case mix index | 1.642 | (1.367–1.972) | < .0001 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.076 | (1.050–1.102) | < .0001 | |
| March–May | 1.031 | (1.006–1.057) | .0137 | |
| June–August | 0.962 | (.935–.990) | .0080 |
| Outcome . | Variable . | IRR . | (95% CI) . | P Value . |
|---|---|---|---|---|
| Broad-spectrum agents predominantly used for hospital-onset/MDR bacteria | ||||
| Baseline level | 6.264 | (4.265–9.200) | < .0001 | |
| Trend preimplementation | 0.993 | (.986–1.000) | .0649 | |
| Change in level at implementation | 1.807 | (1.681–1.940) | < .0001 | |
| Trend postimplementation | 0.996 | (.992–.999) | .0068 | |
| Change in trend postimplementation | 1.002 | (.994–1.010) | .5779 | |
| Case mix index | 1.665 | (1.368–2.026) | < .0001 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.070 | (1.044–1.096) | < .0001 | |
| March–May | 1.014 | (.987–1.043) | .3142 | |
| June–August | 0.960 | (.929–.991) | .0120 | |
| Anti-MRSA agents | ||||
| Baseline level | 4.243 | (2.889–6.229) | < .0001 | |
| Trend preimplementation | 1.000 | (.992–1.008) | .9861 | |
| Change in level at implementation | 1.647 | (1.495–1.814) | < .0001 | |
| Trend postimplementation | 0.993 | (.989–.996) | .0001 | |
| Change in trend postimplementation | 0.993 | (.984–1.002) | .1184 | |
| Case mix index | 1.643 | (1.348–2.002) | < .0001 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.079 | (1.046–1.113) | < .0001 | |
| March–May | 1.043 | (1.010–1.077) | .0098 | |
| June–August | 0.963 | (.928–.999) | .0442 | |
| Broad spectrum agents predominantly used for community-acquired infection | ||||
| Baseline level | 2.635 | (1.780–3.900) | < .0001 | |
| Trend preimplementation | 1.001 | (.992–1.010) | .8777 | |
| Change in level at implementation | 2.433 | (2.199–2.692) | < .0001 | |
| Trend postimplementation | 0.991 | (.988–.995) | < .0001 | |
| Change in trend postimplementation | 0.991 | (.981–1.000) | .0653 | |
| Case mix index | 1.417 | (1.143–1.757) | .0015 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.087 | (1.050–1.126) | < .0001 | |
| March–May | 1.059 | (1.019–1.101) | .0038 | |
| June–August | 0.964 | (.929–.999) | .0450 | |
| Agents predominantly used for surgical site infection prophylaxisa | ||||
| Baseline level | 0.006 | (.001–.029) | < .0001 | |
| Trend preimplementation | 1.024 | (.993–1.056) | .1273 | |
| Change in level at implementation | 2.835 | (2.070–3.883) | < .0001 | |
| Trend postimplementation | 0.991 | (.988–.995) | < .0001 | |
| Change in trend postimplementation | 0.986 | (.955–1.019) | .4028 | |
| Case mix index | 7.032 | (3.007–16.444) | < .0001 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.219 | (1.055–1.408) | .0071 | |
| March–May | 1.011 | (.883–1.157) | .8786 | |
| June–August | 0.937 | (.800–1.098) | .4210 | |
| Overall (composite of all antibiotic groupings) | ||||
| Baseline level | 13.072 | (9.192–18.589) | < .0001 | |
| Trend preimplementation | 0.997 | (.999–1.004) | .4009 | |
| Change in level at implementation | 1.889 | (1.753–2.035) | < .0001 | |
| Trend postimplementation | 0.994 | (.991–.997) | < .0001 | |
| Change in trend postimplementation | 0.997 | (.989–1.004) | .4231 | |
| Case mix index | 1.642 | (1.367–1.972) | < .0001 | |
| Quarter (reference: September–November) | ||||
| December–February | 1.076 | (1.050–1.102) | < .0001 | |
| March–May | 1.031 | (1.006–1.057) | .0137 | |
| June–August | 0.962 | (.935–.990) | .0080 |
The outcome Clostridioides difficile infection was not studied due to low occurrence.
Abbreviations: CI, confidence interval; IRR, incidence rate ratio; MDR, multidrug-resistant; MRSA, methicillin-resistant Staphylococcus aureus.
aRandom effect on change in slope omitted and residuals assumed to be independent and uncorrelated to obtain convergence.
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