Variations in antimicrobial use and cost in more than 2,000 patients with community-acquired pneumonia.
To assess the patterns ofantimicrobial use, costs of antimicrobial therapy, and medical outcomes by institution in patients with community-acquired pneumonia.
PATIENTS AND METHODS
The route, dose, and frequency of administration of all antimicrobial agents prescribed within 30 days of presentation were recorded for 927 outpatients and 1328 inpatients enrolled in the Pneumonia Patient Outcomes Research Team (PORT) multicenter, prospective cohort study.
Total antimicrobial costs were estimated by summing drug costs, using average wholesale price for oral agents and institutional acquisition prices for parenteral agents, plus the costs associated with preparation and administration of parenteral therapy.
Thirty-day outcome measures were mortality, subsequent hospitalization for outpatients, and hospital readmission for inpatients.
Significant variation (P<0.05) in prescribing practices occurred for 17 of the 23 antimicrobial agents used in outpatients across 5 treatment sites, and for 18 of the 20 parenteral agents used in inpatients across 4 treatment sites.
The median duration of antimicrobial therapy for treatment site ranged from 11 to 13 days for outpatients (P=0.01), and from 13 to 15 days for inpatients (P=0.49).
The overall median cost of antimicrobial therapy was $12.90 for outpatients, and ranged from $10.80 to $58.90 among treatment sites (P<0.0001).
The overall median cost of antimicrobial therapy was $228. (...)
Mots-clés Pascal : Infection communautaire, Analyse coût efficacité, Economie santé, Pneumonie, Bactériose, Infection, Antimicrobien, Chimiothérapie, Traitement, Homme, Appareil respiratoire pathologie, Poumon pathologie
Mots-clés Pascal anglais : Community acquired infection, Cost efficiency analysis, Health economy, Pneumonia, Bacteriosis, Infection, Antimicrobial agent, Chemotherapy, Treatment, Human, Respiratory disease, Lung disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0123871
Code Inist : 002B02S02. Création : 22/06/1998.