Vol.74 No.1 January 2026
Impact of the Charlson comorbidity index on trends in advice content from antimicrobial stewardship teams for patients with positive blood cultures
1)Division of Clinical Infectious Diseases, Department of Medicine, School of Medicine, Showa Medical University
2)Division of Infectious Diseases, Department of Medicine, Showa Medical University Northern Yokohama hospital, 35-1 Chigasaki Chuo, Tsuzuki-ku, Yokohama, Kanagawa, Japan
Abstract
We investigated the data of 6,201 patients with initial positive blood cultures in relation to blood culture-positive patient audits. Trends in the patient demographics, isolated bacteria from blood cultures, causative infection sources, hospitalization departments, and recommendations were evaluated using multivariate analysis by the standard least squares method. These findings were reported in a previous study (the Japanese Journal of Chemotherapy 2025; 73: 309-21). This study was aimed at evaluating the impact of incorporating the trend of the Charlson comorbidity index (CCI) into this analysis.
The CCI showed a decreasing trend over time (P<0.0001), and specifically exhibited a decrease with advancing age (P=0.0002). Analysis of the interaction with sex and age revealed conflicting trends: an increasing trend with age in males and a decreasing trend with age in females (P=0.0161). In clinical departments, changes in the impact of multiple departments were observed, and an interaction with CCI was also noted, but no significant changes were observed in other factors. There was minimal change in the content of advice given over time, but advice regarding blood drug concentration measurement (P=0.0260) showed a statistically significant downward trend, which was not evident in the previous study.
By incorporating CCI into this analysis, the relationship between clinical departments and CCI, and the trends in advice content were clarified. Therefore, we recommend incorporating CCI into future analyses.
Key word
antimicrobial stewardship, bacteremia, Charlson comorbidity index, appropriate use, acceptance rate
Received
August 5, 2025
Accepted
September 22, 2025
Jpn. J. Chemother. 74 (1): 45-49, 2026
