Infection Control & Hospital Epidemiology
of the healthy cohort underestimated susceptibility to the study antibiotics. Thus, we were able to define a subset of patients for whom narrower-spectrumempiric antibiotic therapy could be safely administered. Our methodology could be further modified to develop combination antibiograms that estimate the likelihood that combinations of antibiotics will treat a given infectious syndrome, factoring in the local, weighted incidence of pathogens (including polymicrobial infections) causing that syndrome. In the adult population, these antibiograms have been developed for abdominal- biliary infections, urinary tract infections, ventilator-associated pneumonia, and catheter-related bloodstream infections.4,8 This study has several limitations. Prior antibiotic use pre-
scribed at outside institutions could not be captured by our study methodology. The relative proportion of healthy and complex patients, as well as susceptibility rates for various antibiotics, may differ between hospitals; thus, our criteria may not be general- izable. Risk factors for acquisition of antibiotic-resistant organ- isms may differ between institutions. Nonetheless, this study provides proof-of-concept that a syn-
dromic antibiogram for a cohort of healthy children can be accurately identified using ICD-10 codes and other discrete data elements. Our methodology could be automated to inform selection of antibiotic therapy for other patient populations and clinical syndromes. Criteria for a healthy cohort may differ and may be tailored according to each institution’s own risk factors for antibiotic resistant organisms.
Acknowledgments.
Financial support. A medical student research grant to Y.C., through the 2017 Infectious Diseases Society of America (IDSA) Medical Scholars Pro- gram, helped fund expenses related to an abstract/poster presentation at the IDWeek 2017 conference; the abstract reported some preliminary data described in this article.
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Conflicts of interest. All other authors report no conflicts of interest rele- vant to this article.
Supplementary material. To view supplementary material for this article, please visit
https://doi.org/10.1017/ice.2018.246
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