title: Clinical and economic outcomes of conventional amphotericin B-associated nephrotoxicity.
abstract: A retrospective 9-year cohort study was conducted to identify the hospitalization costs, length of hospital stay, and mortality associated with nephrotoxicity (NT) among 494 inpatients who were treated with conventional amphotericin B (CAB). Survival regression methods were used to model the effect of NT. The rate of NT was 12%; the overall in-hospital mortality rate was 22%. After adjustment for confounding, NT was associated with a 2.7-fold higher risk of death (P<.001). Although the unadjusted effects of NT on length of hospital stay and hospitalization costs after the initiation of CAB were consistent with small increases, such effects were not significant in multivariate models (time ratio, 1.2 [P=.2]; cost ratio, 1.1 [P=.8]). The greater the number of days before the onset of NT that were included in the analysis, the greater the apparent effect of NT on costs. CAB-associated NT was associated with increased mortality, but it did not impact the costs and length of hospital stay.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA.
authors.forename: Stephan
authors.initials: S
authors.lastname: Harbarth
authors.forename: John P
authors.initials: JP
authors.lastname: Burke
authors.forename: James F
authors.initials: JF
authors.lastname: Lloyd
authors.forename: R Scott
authors.initials: RS
authors.lastname: Evans
authors.forename: Stanley L
authors.initials: SL
authors.lastname: Pestotnik
authors.forename: Matthew H
authors.initials: MH
authors.lastname: Samore
mesh_terms: D000666:Amphotericin B / Q000009:adverse effects* / Q000191:economics; D000935:Antifungal Agents / Q000009:adverse effects* / Q000191:economics; D015331:Cohort Studies; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009026:Mortality; D051437:Renal Insufficiency / Q000139:chemically induced / Q000191:economics* / Q000401:mortality; D012189:Retrospective Studies
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B