Volume 26, Number 10—October 2020
Research Letter
Inappropriate Administration of Rabies Postexposure Prophylaxis, Cook County, Illinois, USA
Hannah D. Steinberg, Kelley Bemis, Mabel M. Frias, and Demian Christiansen
Table
PEP recipients and factors associated with inappropriate administration of PEP, suburban Cook County, IL, 2015–2018*
| Variable | Total, no. (%), n = 611 | Exposure met ACIP guidelines for PEP administration, no. (%) |
Unadjusted GEE model† OR (95% CI) | Adjusted GEE model‡ aOR (95% CI) | |
|---|---|---|---|---|---|
| Yes, n = 272 | No, n = 339 | ||||
| District§ | |||||
| North | 309 (50.6) | 125 (45.9) | 184 (54.3) | Referent | Referent |
| West | 131 (21.4) | 54 (19.9) | 77 (22.7) | 0.97 (0.52–1.80) | 0.76 (0.39–1.47) |
| Southwest | 82 (13.4) | 47 (17.3) | 35 (10.3) | 0.51 (0.27–0.94) | 0.41 (0.20–0.83) |
| South |
89 (14.6) |
46 (16.9) |
43 (12.7) |
0.64 (0.35–1.15) |
0.52 (0.27–0.98) |
| Age, y | |||||
| 0–5 | 47 (7.7) | 24 (8.8) | 23 (6.8) | 0.84 (0.44–1.62) | 0.74 (0.36–1.50) |
| 6–17 | 170 (27.8) | 64 (23.5) | 106 (31.3) | 1.46 (0.92–2.32) | 1.49 (0.90–2.45) |
| 18–25 | 50 (8.2) | 23 (8.5) | 27 (8.0) | 1.03 (0.55–1.94) | 1.20 (0.53–2.72) |
| >26 |
344 (56.3) |
161 (59.2) |
183 (54.0) |
Referent |
Referent |
| Sex | |||||
| F | 317 (51.9) | 131 (48.2) | 186 (54.9) | Referent | Referent |
| M |
294 (48.1) |
141 (51.8) |
153 (45.1) |
0.76 (0.53–1.10) |
0.77 (0.51–1.15) |
| Exposing animal | |||||
| Bat | 393 (64.3) | 181 (66.5) | 212 (62.5) | Referent | Referent |
| Cat | 35 (5.7) | 6 (2.2) | 29 (8.6) | 4.13 (1.62–10.50) | 4.15 (1.49–11.60) |
| Dog | 111 (18.2) | 39 (14.3) | 72 (21.2) | 1.58 (0.91–2.72) | 2.05 (1.07–3.96) |
| Raccoon | 31 (5.1) | 26 (9.6) | 5 (1.5) | 0.16 (0.06–0.45) | 0.19 (0.06–0.57) |
| Other |
41 (6.7) |
20 (7.4) |
21 (6.2) |
0.90 (0.45–1.79) |
0.93 (0.43–2.01) |
| HD consult¶ | |||||
| Yes | 183 (30.0) | 138 (50.7) | 45 (13.3) | 0.15 (0.09–0.23) | 0.13 (0.08–0.22) |
| No | 428 (70.0) | 134 (49.3) | 294 (86.7) | Referent | Referent |
*ACIP, Advisory Committee on Immunization Practices; aOR, adjusted odds ratio; GEE, generalized estimating equation; HD, health department; PEP, rabies postexposure prophylaxis; OR, odds ratio.
†Bivariate GEE model for PEP inappropriateness as a function of the given categorical variable.
‡Multivariable GEE model for PEP inappropriateness as a function of all the predictors included in the table.
§Suburban Cook County residential district of patient’s home address.
¶Whether healthcare provider contacted a state or local health department to discuss appropriateness of PEP.
Page created: July 28, 2020
Page updated: September 17, 2020
Page reviewed: September 17, 2020
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