Cost of care and antibiotic prescribing attitudes for community-acquired complicated intra-abdominal infections in Italy: a retrospective study View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2014-06-20

AUTHORS

Lidia Dalfino, Francesco Bruno, Sergio Colizza, Ercole Concia, Andrea Novelli, Fabrizio Rebecchi, Federico Spandonaro, Cristina Alato

ABSTRACT

IntroductionComplicated intra-abdominal infections (cIAIs) are a common cause of morbidity worldwide, and in spite of improvements in patient care, therapeutic failure still occurs, impacting in-hospital resource consumption. This study aimed to assess the costs associated with the treatment of community-acquired cIAIs, from the Italian National Health Service perspective.MethodsThis retrospective study analyzed the charts of patients who were discharged from four Italian university hospitals between January 1 and December 31, 2009 with a primary diagnosis of community-acquired cIAIs. Patient characteristics, diagnosis, surgical procedure, antibiotic therapy, and length of hospital stay were all recorded and the cost of total hospital care was estimated. Costs were calculated in Euros at 2009 values.ResultsThe records of 260 patients (mean age 48.9 years; 57% males) were analyzed. The average cost of care for a patient hospitalized due to cIAI was €4385 (95% CI 3650–5120), with an average daily cost of €419 (95% CI 378–440). Antibiotic therapy represented just under half (44.3%) of hospitalization costs. The strongest predictor of the increase in hospital costs was clinical failure: patients who clinically failed received an average of 8.2 additional days of antibiotic therapy and spent 11 more days in hospital compared with patients who responded to first-line therapy (both p < 0.05 vs. patients who were successfully treated). Furthermore, they incurred €5592 in additional hospitalization costs (2.88 times the cost associated with clinical success) with 53% (€2973) of the additional costs attributable to antibiotic therapy. Overall, antibiotic appropriateness rate was 78.8% (n = 205), and was significantly higher in patients receiving combination therapy compared with those treated with monotherapy (97.3% vs. 64.6%).ConclusionThe results of this study suggest that hospitals need to be aware of the clinical and economic consequences of antibiotic therapy of cIAIs and to reduce overall resource use and costs by improving the rate of success with appropriate initial empiric therapy. More... »

PAGES

39

References to SciGraph publications

  • 2002-11-13. Cost of Care for Inpatients with Community-Acquired Intra-Abdominal Infections in EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
  • 2004-08-21. Effect of inappropriate initial empiric antibiotic therapy on outcome of patients with community-acquired intra-abdominal infections requiring surgery in EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
  • 2012-11-29. Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study in WORLD JOURNAL OF EMERGENCY SURGERY
  • 2013-01-08. 2013 WSES guidelines for management of intra-abdominal infections in WORLD JOURNAL OF EMERGENCY SURGERY
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    http://scigraph.springernature.com/pub.10.1186/1749-7922-9-39

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    http://dx.doi.org/10.1186/1749-7922-9-39

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    https://app.dimensions.ai/details/publication/pub.1006589355

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/25028594


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