The Effect of Selected Hospital Characteristics on the Timeliness of Antibiotic Administration for Pneumonia

In this study, we compared large urban teaching hospitals (group 1) with small nonurban nonteaching hospitals (group 2) in terms of administering antibiotics to patients admitted with pneumonia within 4 hours of hospital arrival. The following 2 independent data sets were used: hospital-reported data (comprising 22 193 patients with pneumonia discharged from Michigan hospitals in 2003) and hospital surveillance data (comprising 1053 randomly selected patients with pneumonia in Michigan from 2002 to 2004, reviewed by a central data abstraction center). Using hospital-reported data, the mean antibiotic timeliness rates were 65.9% (95% confidence interval [CI], 61.5%-70.2%) for group 1 and 79.5% (95% CI, 76.8%-80.2%) for group 2 (P.001). Using hospital surveillance data, the mean antibiotic timeliness rates were 58.2% (95% CI, 52.9%-63.5%) for group 1 and 70.1% (95% CI, 63.7%-76.6%) for group 2 (P =.01). These results support efforts to reduce logistical barriers to pneumonia antibiotic timeliness at large hospitals. (Am J Med Qual 2007;22:259-264).