title: Clinical and economic outcomes in respiratory tract infections: The impact of bacterial resistance.
abstract: Drug acquisition cost is an important component in the analysis of economic and clinical outcomes in the treatment of respiratory tract infections (RTIs). However, bacterial resistance has emerged as a crucial variable that must also be considered. Drug-resistant infections result in more expensive drug therapy, longer hospital stays, and increased mortality. The high prevalence of community-acquired pneumonia (CAP), as well as the continuing growth in resistant pathogens, make RTIs an appropriate model for studying methods of cost-containment without sacrificing clinical outcome. The University of Kentucky Medical Center has developed a uniform CAP treatment pathway to minimize costs and maximize outcomes. First-line therapy in this model is doxycycline monotherapy, high-dose amoxicillin plus azithromycin, or levofloxacin monotherapy. One major future concern in selecting antibacterial agents for CAP is the spread of macrolide- and fluoroquinolone-resistant Streptococcus pneumoniae.
authors: University of Kentucky, Lexington, 40536, USA.
authors: Robert P
authors: RP
authors: Rapp
mesh_terms: D000658:Amoxicillin / Q000191:economics / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D017963:Azithromycin / Q000191:economics / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000191:economics* / Q000382:microbiology; D004318:Doxycycline / Q000191:economics / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D006801:Humans; D007629:Kentucky; D064704:Levofloxacin; D015242:Ofloxacin / Q000627:therapeutic use; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000191:economics* / Q000382:microbiology; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000191:economics / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000187:drug effects; D016896:Treatment Outcome; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents; D064704:Levofloxacin; D000658:Amoxicillin; D017963:Azithromycin; D015242:Ofloxacin; D004318:Doxycycline