What is the Cost of Antibiotic Failure?

The Age of Antibiotics may soon be over since many bacteria are now immuned to antibiotics. What can you do?  Let’s follow this example and see how many lives are lost to antibiotics and how much antibiotics failures add to hospital costs.

You are in the hospital with an infection that your doctor has not identified.  He decides to give you a broad-band antibiotic in the hopes it will help.  Is this a shot in the dark?  Perhaps. Let’s see what the scientists say:

Background: Initial antibiotic therapy in hospitalized adults with complicated intra-abdominal infection (cIAI) usually is empiric. We explored the economic consequences of failure of such therapy in this patient population.

Hospital Patient

 

Methods: Using a large U.S. multi-institutional database, we identified all hospitalized adults admitted between April 1, 2003, and March 31, 2004; who had any cIAI; underwent laparotomy, laparoscopy, or percutaneous drainage of an intra-abdominal abscess (“surgery”); and received intravenous (IV) antibiotics. Initial therapy was characterized in terms of all IV antibiotics received, on the day of or one day before initial surgery. Antibiotic failure was designated on the basis of the need for reoperation or receipt of other IV antibiotics postoperatively. Switches to narrower spectrum agents and changes in regimen prior to discharge with no other evidence of clinical failure were not counted as antibiotic failures. Using multivariable linear regression, duration of IV antibiotic therapy, hospital length of stay, and total inpatient charges were compared between patients who did and did not fail initial therapy. Mortality was compared using multivariable logistic regression.

Results:

  • Among 6,056 patients who met the study entrance criteria, 22.4% failed initial antibiotic therapy.
  • Patients who failed received an additional 5.6 days of IV antibiotic therapy (10.4 total days [95% confidence interval 10.1, 10.8] days vs. 4.8 total days [4.8, 4.9] for those not failing), were hospitalized an additional 4.6 days (11.6 total days [11.3, 11.9] vs. 6.9 total days [6.8, 7.0], respectively)
  • They incurred $6,368 in additional inpatient charges ($16,520 [$16,131, $16,919] vs. $10,152 [$10,027, $10,280]) (all, p < 0.01).
  • They also were more likely to die in the hospital (9.5% vs. 1.3%; multivariable odds ratio 3.58 [95% confidence interval 2.53, 5.06]).

Conclusions:

Failure of initial IV antibiotic therapy in hospitalized adults with cIAIs is associated with longer hospitalization, higher hospital charges, and a higher mortality rate.

Many thanks to for this informative article to; John Edelsberg, Ariel Berger, Scott Schell, Rajiv Mallick, Andreas Kuznik, Gerry Oster. Surgical Infections. June 2008, 9(3): 335-347. doi:10.1089/sur.2006.100.  Published in Volume: 9 Issue 3: June 20, 2008

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About CareMan
I am the CareMan, have been for 7 years now. I really do care about YOU and getting YOU back to great, natural health, so long as you have an open mind.

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