title: Direct economic effect following mupirocin therapy failure among patients with uncomplicated skin and skin-structure infections in a large population-based cohort.
abstract: The goal of the study was to derive initial costs associated with failure of initial mupirocin therapy among patients diagnosed with uncomplicated skin and skin-structure infections (uSSSIs). A retrospective observational analysis of medical, pharmacy, and enrollment records was conducted using data from the National Managed Care Benchmark Database. Patients were classified as failing treatment with mupirocin if they either filled a second antibiotic commonly used to treat uSSSIs five to 30 days after their index mupirocin prescription fill or experienced a uSSSI-related hospitalization within 30 days after the index mupirocin prescription fill. Among 12,650 failure episodes, 11,867 (93.8%) required a second antibiotic contributing a mean cost of $62 per prescription. Approximately 4,782 (37.8%) had an associated outpatient encounter resulting in a mean cost of $221 per encounter. Nine percent of failures required a hospitalization with a mean cost of $6,597 per hospitalization. These medical, hospital, and pharmacy costs translated into an expected cost of $735.45 per mupirocin failure among patients with uSSSIs. The management of uSSSIs is costly in terms of health care resource use and direct health care expenditures when initial therapy with mupirocin fails.
authors.affiliation: Xcenda, Palm Harbor, Florida, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Meissner
authors.forename: Steven P
authors.initials: SP
authors.lastname: Burch
authors.forename: Matt
authors.initials: M
authors.lastname: Sarnes
authors.forename: Chad
authors.initials: C
authors.lastname: Green
authors.forename: Marybeth
authors.initials: M
authors.lastname: Dalessandro
authors.forename: C Ron
authors.initials: CR
authors.lastname: Cantrell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016712:Mupirocin / Q000627:therapeutic use*; D017063:Outcome Assessment, Health Care / Q000191:economics*; D012189:Retrospective Studies; D017192:Skin Diseases, Bacterial / Q000188:drug therapy*; D013211:Staphylococcus aureus / Q000472:pathogenicity; D013297:Streptococcus pyogenes / Q000472:pathogenicity; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents; D016712:Mupirocin