Primary and secondary outcomes (positive differences indicate higher values at the intervention hospital)
| Pre-intervention n % (95% CI) | Post-intervention number % (95% CI) | Adjusted absolute change* (95% CI, p value) | Unadjusted absolute change, 95% CI, p value) | Adjusted difference in absolute change from baseline† % | Unadjusted difference in absolute change from baseline % | |||
|---|---|---|---|---|---|---|---|---|
| Hospital: | Study, n = 181 | Control, n = 60 | Study, n = 209 | Control, n = 53 | ||||
| *Absolute change = intervention site post implementation−control site post implementation. | ||||||||
| †Difference in absolute change from baseline = (intervention post implementation–intervention pre implementation) – (control post implementation–control pre implementation). | ||||||||
| ‡Statistically significant pre intervention difference between intervention and control groups (p = 0.03). | ||||||||
| §Excludes deaths and patients with a length of stay >30 days. | ||||||||
| Number of patients receiving appropriate antibiotics within 4 h of admission | 60 33% (26% to 41%) | 19 32% (20% to 45%) | 118 56% (49% to 63%) | 19 36% (23% to 50%) | 17% (1% to 32%), 0.035 | 20% (5% to 35%), 0.009 | 17 | 19 |
| Number of patients receiving appropriate antibiotics within 8 h of admission | 90 50% (42% to 57%) | 27 45% (32% to 58%) | 157 75% (69% to 81%) | 38 72% (58% to 83%) | −1% (−14% to 14%), 1.0 | 3% (−10% to 17%), 0.6 | −1 | −2 |
| Number of patients receiving appropriate initial antibiotics | 136 75% (68% to 81%) | 37 62%‡ (48% to 74%) | 182 87% (82% to 91%) | 41 77% (64% to 88%) | 10% (−1% to 22%), 0.08 | 10% (−1% to 21%), 0.08 | 6 | −3 |
| Time to first dose of antibiotic given in hospital—number within 4 h of admission | 91 50% (43% to 58%) | 30 50% (37% to 63%) | 150 72% (65% to 78%) | 27 51% (37% to 65%) | 15% (2% to 29%), 0.028 | 21% (7% to 35%), 0.004 | 13 | 20 |
| Length of stay§: | ||||||||
| Mean (95% CI) | 7 (6 to 8) | 7 (5 to 9) | 7 (6 to 8) | 8 (6 to 9) | p = 0.5 | −1 mean day | 1 mean day | |
| Median (95% CI) | 5 (4 to 6) | 5 (3 to 7) | 6 (5 to 7) | 6 (5 to 7) | Cox regression: | |||
| 30-day mortality | 34 19% (14% to 26%) | 13 22% (12% to 35%) | 38 19% (14% to 25%) | 5 10% (3% to 21%) | 5% (17% to −7%), 0.4 | 9% (20% to −2%), 0.1 | −4 | −12 |
| Data not available | 5 | 1 | 5 | 1 | ||||