A cost analysis of a broad-spectrum antibiotic therapy in the empirical treatment of health care-associated infections in cirrhotic patients
| Autor: | Cristina Lucidi, Mario Venditti, Oliviero Riggio, Manuela Merli, Vincenza Di Gregorio, Giancarlo Ceccarelli |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Diagnosis-related group Cirrhosis medicine.drug_class Total cost Economics Econometrics and Finance (miscellaneous) Antibiotics Context (language use) 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Profitability Intensive care medicine health care economics and organizations Original Research business.industry Antibiotic failure Health Policy Medical record Cost saving medicine.disease 2001 ClinicoEconomics and Outcomes Research Clinical trial 030220 oncology & carcinogenesis Cost analysis 030211 gastroenterology & hepatology business |
| Zdroj: | ClinicoEconomics and Outcomes Research: CEOR |
| ISSN: | 1178-6981 |
| Popis: | Cristina Lucidi,1 Vincenza Di Gregorio,1 Giancarlo Ceccarelli,2 Mario Venditti,2 Oliviero Riggio,1 Manuela Merli1 1Gastroenterology, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy; 2Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome,Italy Background: Early diagnosis and appropriate treatment of infections in cirrhosis are crucial. As new guidelines in this context, particularly for health care-associated (HCA) infections, would be needed, we performed a trial documenting whether an empirical broad-spectrum antibiotic therapy is more effective than the standard one for these infections. Because of the higher daily cost of broad-spectrum than standard antibiotics, we performed a cost analysis to compare: 1) total drug costs, 2) profitability of hospital admissions. Methods: This retrospective observational analysis was performed on patients enrolled in the trial NCT01820026, in which consecutive cirrhotic patients with HCA infections were randomly assigned to a standard vs a broad-spectrum treatment. Antibiotic daily doses, days of treatment, length of hospital stay, and DRG (diagnosis-related group) were recorded from the clinical trial medical records. The profitability of hospitalizations was calculated considering DRG tariffs divided by length of hospital stay.Results: We considered 84 patients (42 for each group). The standard therapy allowed to obtain a first-line treatment cost lower than in the broad-spectrum therapy. Anyway, the latter, being related to a lower failure rate (19% vs 57.1%), resulted in cost saving in terms of cumulative antibiotic costs (first- and second-line treatments). The mean cost saving per patient for the broad-spectrum arm was €44.18 (–37.6%), with a total cost saving of about €2,000. Compared to standard group, we observed a statistically significant reduction in hospital stay from 17.8 to 11.8 days (p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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