Antibiotic de-escalation therapy in patients with community-acquired nonbacteremic pneumococcal pneumonia View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-10-25

AUTHORS

Atsushi Uda, Issei Tokimatsu, Chihiro Koike, Kayo Osawa, Katsumi Shigemura, Takeshi Kimura, Takayuki Miyara, Ikuko Yano

ABSTRACT

Background De-escalation therapy is recommended as an effective antibiotic treatment strategy for several infectious diseases. While there is limited evidence supporting its clinical and cost-effective outcomes in patients with community-acquired bacteremic pneumonia, there is no evidence in patients with nonbacteremic pneumonia. Objective This study aimed to evaluate the antibiotic costs in patients who did and did not receive de-escalation therapy, based on the 2017 Japanese guidelines for the management of community-acquired nonbacteremic pneumococcal pneumonia of the Japanese Respiratory Society (JRS). Setting Kobe university hospital, Japan. Methods A retrospective case series review including antibiotic use and length of hospital stay was conducted using the medical records from April 2008 to May 2019 at a university hospital in Japan. Main outcome measure Impact of antibiotic de-escalation therapy on the antibiotic costs. Results Among 55 patients who were eligible, the treating physicians de-escalated antibiotics in 28 (51%). The differences in the median length of hospital stay and the incidence of adverse drug reactions between the two groups were not statistically significant (p = 0.67 and 1.0, respectively). However, the median total antibiotic cost per infected patient in the de-escalated group was significantly lower than that in the non-de-escalated group [$269.8 ($195–$389) vs. $420.5 ($221–$799), p = 0.048]. Conclusion Antibiotic de-escalation based on the 2017 JRS guidelines leads to a reduction in total antibiotic costs for the management of community-acquired nonbacteremic pneumococcal pneumonia. More... »

PAGES

1611-1617

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11096-019-00926-z

DOI

http://dx.doi.org/10.1007/s11096-019-00926-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1122095326

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31654366


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