Significant Regional Differences in Antibiotic Use Across 576 U.S. Hospitals and 11,701,326 Million Adult Admissions, 2016 – 2017

Abstract Background Quantifying the amount and diversity of antibiotic use in United States hospitals assists antibiotic stewardship efforts but is hampered by limited national surveillance. Our study aimed to address this knowledge gap by examining adult antibiotic use across 576 hospitals and nearly 12 million encounters in 2016 – 2017. Methods We conducted a retrospective study of patients aged ≥ 18 years discharged from hospitals in the Premier Healthcare Database between January 1, 2016 – December 31, 2017. Using daily antibiotic charge data, we mapped antibiotics to mutually-exclusive classes and to spectrum of activity categories. We evaluated relationships between facility and case-mix characteristics and antibiotic use in negative binomial regression models.