Cost Assessment of Antibiotics in an Obstetric Intensive Care Unit: A Pharmaco-Economic Study

Introduction: The consumption of antibiotics in obstetric intensive care represents a major challenge, combining the need for effective treatment of severe maternal infections with the imperative to control costs and combat antibiotic resistance. This study aims to evaluate the direct cost of antibiotic therapy and analyze consumption profiles in an obstetric intensive care unit in Morocco. Materials and Methods: A retrospective, descriptive, single-center study was conducted over 12 months (January-December 2024) in the obstetric intensive care unit of the CHU Ibn Rochd of Casablanca. All patients (n = 378) who received antibiotic therapy were included. Antibiotic consumption was quantified in Defined Daily Dose (DDD) per 1000 hospitalization days (HD). The economic analysis focused on the direct cost of antibiotics, based on hospital unit prices, with conversion into euros. Results: The total annual cost of antibiotics amounted to 38,650 e, with an average cost of 102.25 e per patient. Healthcare-associated infections (HAIs) accounted for 67.9% of the total cost, with an additional cost of 13,819 e compared to community infections. Total consumption was 1,383.7 DDD/1000 HD, dominated by beta-lactams (618.6 DDD/1000 HD). The incidence of HAIs was 30.7%, with the main sites being bacteremias (27.9%) and urinary tract infections (27.4%). The predominant pathogens were Escherichia coli for urinary infections, Pseudomonas aeruginosa and Acinetobacter baumannii for pneumonias. Conclusion: The cost of antibiotics in obstetric intensive care is considerable, mainly driven by the management of healthcare-associated infections. Optimizing practices through antibiotic stewardship programs and strengthening HAI prevention measures is essential to control expenses and preserve the effectiveness of these vital therapies.