Document Detail


Treatment failure in pneumonia: impact of antibiotic treatment and cost analysis.
MedLine Citation:
PMID:  21965229     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to investigate treatment failure (TF) in hospitalised community-acquired pneumonia (CAP) patients with regard to initial antibiotic treatment and economic impact. CAP patients were included in two open, prospective multicentre studies assessing the direct costs for in-patient treatment. Patients received treatment either with moxifloxacin (MFX) or a nonstandardised antibiotic therapy. Any change in antibiotic therapy after >72 h of treatment to a broadened antibiotic spectrum was considered as TF. Overall, 1,236 patients (mean ± SD age 69.6 ± 16.8 yrs, 691 (55.9%) male) were included. TF occurred in 197 (15.9%) subjects and led to longer hospital stay (15.4 ± 7.3 days versus 9.8 ± 4.2 days; p < 0.001) and increased median treatment costs (€2,206 versus €1,284; p<0.001). 596 (48.2%) patients received MFX and witnessed less TF (10.9% versus 20.6%; p < 0.001). After controlling for confounders in multivariate analysis, adjusted risk of TF was clearly reduced in MFX as compared with β-lactam monotherapy (adjusted OR for MFX 0.43, 95% CI 0.27-0.68) and was more comparable with a β-lactam plus macrolide combination (BLM) (OR 0.68, 95% CI 0.38-1.21). In hospitalised CAP, TF is frequent and leads to prolonged hospital stay and increased treatment costs. Initial treatment with MFX or BLM is a possible strategy to prevent TF, and may thus reduce treatment costs.
Authors:
S R Ott; B M Hauptmeier; C Ernen; P M Lepper; E Nüesch; M W Pletz; J Hecht; T Welte; T T Bauer
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article     Date:  2011-09-29
Journal Detail:
Title:  The European respiratory journal     Volume:  39     ISSN:  1399-3003     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-03-01     Completed Date:  2012-07-16     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  611-8     Citation Subset:  IM    
Affiliation:
Dept of Respiratory Medicine, University Hospital Berne, Inselspital and University of Berne, 3010 Berne, Switzerland. sebastian.ott@insel.ch
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Anti-Bacterial Agents / therapeutic use*
Aza Compounds / therapeutic use*
Community-Acquired Infections / drug therapy,  economics
Drug Therapy, Combination / economics
Female
Health Care Costs
Humans
Length of Stay / economics
Macrolides / therapeutic use*
Male
Middle Aged
Pneumonia / drug therapy*,  economics
Quinolines / therapeutic use*
Treatment Failure
beta-Lactams / therapeutic use*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Aza Compounds; 0/Macrolides; 0/Quinolines; 0/beta-Lactams; U188XYD42P/moxifloxacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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