[Direct cost of antibiotic therapy prescribed for nosocomial bacteremia. Prospective study during 6 months at a CHU (University Hospital Center)].
A six-month prospective study of costs associated with antimicrobial therapy in nosocomial bacteremia was conducted from November 1, 1995 to April 30, 1996 in a 1837-bed teaching hospital, with the help of the hospital pharmacists and hospital hygiene unit. Only the costs due to the antimicrobials themselves were taken into account. A total of 238 cases of nosocomial bacteremia occurred during the study period. The total direct cost of antimicrobial therapy was 444,931 French francs (FF), i.e., 6.8% of total expenditures for antimicrobials. Mean cost per case was 1869 FF, and was 2.6-fold higher in the 21 patients with bacteremia due to more than one organism (P = 0.03). CAses with an identifiable portal of entry contributed 75% of the total cost. Portals of entry associated with the highest cost included central venous lines (103,928 FF) and urinary tract infections (50,810 FF). Although 20% of nosocomial bacteremias due to coagulase-negative staphylococci did not lead to antimicrobial therapy, the remaining 80% contributed 40.8% of the total cost, followed by nosocomial bacteremias due to Escherichia coli with 19.7% of the total cost. Thirty-seven patients (15.5%) did not receive specific antimicrobial therapy, for the following reasons: death before treatment initiation, transfer to another hospital, antimicrobial therapy initiated earlier for another infection elsewhere in the body due to a different organism, or other form of treatment. The results of this study highlight the need for prevention.
Unité d'Hygiène Hospitalière et Microbiologie, Hôpital Nord CHU, Amiens, France.
F
F
Daumal
C
C
Etienne
P
P
Votte
P
P
Bou
B
B
Canarelli
F
F
Desablens
J L
JL
Schmit
F
F
Eb
D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000191:economics* / Q000209:etiology / Q000382:microbiology; D002405:Catheterization, Central Venous / Q000009:adverse effects; D003428:Cross Infection / Q000188:drug therapy / Q000191:economics*; D016527:Drug Costs; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000191:economics; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000191:economics; D017721:Hospital Costs; D006785:Hospitals, University / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D011446:Prospective Studies; D014552:Urinary Tract Infections / Q000150:complications / Q000191:economics
D000900:Anti-Bacterial Agents
Coût direct de l'antibiothérapie prescrite dans les bactériémies nosocomiales. Etude prospective pendant 6 mois dans un CHU.