Kamal M.F. Itani (Veterans Administration Boston Health Care System and Boston University, Boston, Massachusetts, USA) Kasem S. Akhras (Johnson & Johnson Pharmaceutical Services, LLC, Raritan, New Jersey, USA) Robert Stellhorn (Johnson & Johnson Pharmaceutical Services, LLC, Raritan, New Jersey, USA) Alvaro Quintana (Johnson & Johnson Pharmaceutical Services, LLC, Raritan, New Jersey, USA) David Budd (Johnson & Johnson Pharmaceutical Services, LLC, Raritan, New Jersey, USA) Sanjay Merchant (Johnson & Johnson Pharmaceutical Services, LLC, Raritan, New Jersey, USA)
Abstract
BackgroundBackground Delayed coverage of pathogens including meticillin-resistant Staphylococcus aureus (MRSA) in pneumonia and bacteraemia has been associated with increased mortality and length of hospital stay (LOS). However, less is known about the impact of delayed appropriate coverage in complicated skin and skin-structure infections (cSSSIs). Abstract: ObjectiveObjective To evaluate the clinical and economic outcomes associated with early versus late use of vancomycin in the management of patients hospitalized for cSSSIs. Abstract: MethodsMethods Retrospective analysis was performed using an inpatient claims database of >500 US hospitals in 2005. Using prescription claims, patients with primary or secondary cSSSI admissions were classified into three groups: 1 - early vancomycin monotherapy; 2 - early vancomycin combination therapy; 3 - late vancomycin therapy. Outcomes studied included LOS and inpatient hospital costs. One-way analysis of variance was used for unadjusted analysis and multivariate regression methods were used to control for co-variates. Abstract: ResultsResults A total of 34 942 patients (27.78% of all patients with cSSSIs) were treated with vancomycin. Mean age was 54.7 years and 54.3% of the patients were males. Mean unadjusted total LOS was 8.46, 9.44 and 13.2 days, and hospital costs in 2005 values were $US10 211.94, $US12 361.94 and $US18 344.00 for groups 1, 2 and 3, respectively. In-hospital mortality rate was highest in group 3 (4.18%) and lowest in group 1 (1.75%). Generalized linear models used to control for potential confounding variables between early versus late vancomycin use suggest that among cSSSI patients late vancomycin use is an independent predictor of higher LOS and costs. Abstract: ConclusionConclusion In this large inpatient database, later vancomycin use in patients with cSSSIs appears to be significantly associated with higher LOS and total costs.
Download Info
To download:
If you experience problems downloading a file, check if you have the
proper application to
view it first. Information about this may be contained
in the File-Format links below. In case of further problems read
the IDEAS help
page. Note that these files are not on the IDEAS
site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Publisher Info
Article provided by Wolters Kluwer Health | Adis in its journal PharmacoEconomics.
For technical questions regarding this item, or to correct its listing, contact: (Remco Bouckaert).
Related research
Keywords:
Find related papers by JEL classification: C - Mathematical and Quantitative Methods D - Microeconomics I - Health, Education, and Welfare Z - Other Special Topics I1 - Health, Education, and Welfare - - Health I19 - Health, Education, and Welfare - - Health - - - Other I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets