Clinical and financial impact of intravenous erythromycin therapy in hospitalized patients.
OBJECTIVE
To determine the economic consequences of intravenous erythromycin use in hospital patients in a variety of clinical circumstances.


METHODS
Retrospective cohort study of patients with specified primary diagnosis-related group discharge diagnoses treated from January 1, 1990, to December 31, 1994, who received erythromycin, and a matched cohort group from the same period who did not receive erythromycin.


METHODS
LDS Hospital, Salt Lake City, UT, a 520-bed teaching hospital.


METHODS
A long-term archive of clinical and financial data from a computerized hospital information system was searched for patients meeting a strict case definition. This archive contained information on erythromycin exposure as well as concurrent drug therapy and adverse drug events that had been prospectively evaluated during hospitalization throughout the study and cohort periods. Detailed costs were available for each patient.


METHODS
Attributable differences in lengths of stay and total costs determined using linear regression modeling.


RESULTS
For 797 erythromycin patients and 2771 cohort patients, we found an attributable increased length of stay of 2.14 days and an increased cost of hospitalization of $6061 for erythromycin case patients. Case patients also had a significantly increased risk of adverse drug events. Linear regression modeling showed that erythromycin use was significantly related to increased length of stay and cost of hospitalization.


CONCLUSIONS
Intravenous erythromycin use has been associated with significant increases in hospital length of stay and total hospital cost.
Classen
D C
DC
University of Utah, Salt Lake City, USA.
Burke
J P
JP
Pestotnik
S L
SL
Lloyd
J F
JF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D003953:Diagnosis-Related Groups; D004917:Erythromycin / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D005260:Female; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007275:Injections, Intravenous; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents; D004917:Erythromycin