Abstract
Objectives: The rising incidence of urinary tract infections (UTIs) attributable to Escherichia coli resistant isolates is becoming a serious public health concern. Although global rates of infection vary considerably by region, the growing prevalence of this uropathogen has been associated with a high economic burden and health strain. This study aims: (1) to estimate the dif-ferences in clinical and economic outcomes between 2 groups of adult hospitalized patients with UTIs from E. coli resistant and susceptible bacteria and (2) to investigate drivers of this cost from a payer's perspective.Methods: A prospective multicenter cohort study was conducted in 10 hospitals in Lebanon. The cost analysis followed a bottom-up microcosting approach; a linear regression was constructed to evaluate the predictors of hospitalization costs and a Cox proportional hazards model was used to estimate the impact of resistance on length of stay (LOS) and in-hospital mortality.Results: Out of 467 inpatients, 250 cases were because of resistant E. coli isolates. Results showed that patients with resistant uropathogens had 29% higher mean total hospitalization costs ($3429 vs $2651; P = .004), and an extended median LOS (6 days vs 5 days; P = .020) compared with susceptible cohorts. The selection of resistant bacteria and the Charlson comorbidity index predicted higher total hospitalization costs and in-hospital mortality.Conclusion: In an era of increased pressure for cost containment, this study showed the burden of treating UTIs resulting from resistant bacteria. The results can inform cost-effectiveness analyses that intend to evaluate the benefit of a national action plan aimed at decreasing the impact of antibiotic resistance.
Original language | English |
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Pages (from-to) | 90-98 |
Number of pages | 9 |
Journal | Value in Health Regional Issues |
Volume | 25 |
DOIs | |
Publication status | Published - 1 Sept 2021 |
Keywords
- antimicrobial resistance
- economic burden-Lebanon
- urinary tract infection
- BETA-LACTAMASE PRODUCTION
- ANTIMICROBIAL RESISTANCE
- ANTIBACTERIAL RESISTANCE
- REDUCES LENGTH
- E.-COLI
- HEALTH
- CARE
- IMPACT
- COSTS
- DEFINITION