Ott, SR; Hauptmeier, BM; Ernen, C; Lepper, PM; Nüesch, E; Pletz, MW; Hecht, J; Welte, T; Bauer, TT (2012). Treatment failure in pneumonia: Impact of antibiotic treatment and cost analysis. European respiratory journal, 39(3), pp. 611-8. Sheffield, UK: European Respiratory Society 10.1183/09031936.00098411
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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.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology 04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM) |
UniBE Contributor: |
Ott, Sebastian Robert, Nüesch, Eveline |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0903-1936 |
Publisher: |
European Respiratory Society |
Language: |
English |
Submitter: |
Factscience Import |
Date Deposited: |
04 Oct 2013 14:21 |
Last Modified: |
05 Dec 2022 14:05 |
Publisher DOI: |
10.1183/09031936.00098411 |
PubMed ID: |
21965229 |
Web of Science ID: |
000300883800016 |
BORIS DOI: |
10.7892/boris.6903 |
URI: |
https://boris.unibe.ch/id/eprint/6903 (FactScience: 211971) |