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Economic Burden of Urinary Tract Infections From Antibiotic-Resistant Escherichia coli Among Hospitalized Adult Patients in Lebanon: A Prospective Cohort Study.
- Source :
-
Value in health regional issues [Value Health Reg Issues] 2021 Sep; Vol. 25, pp. 90-98. Date of Electronic Publication: 2021 Apr 11. - Publication Year :
- 2021
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Abstract
- Objectives: The rising incidence of urinary tract infections (UTIs) attributable to Escherichia coli resistant isolates is becoming a serious public health concern. Although global rates of infection vary considerably by region, the growing prevalence of this uropathogen has been associated with a high economic burden and health strain. This study aims: (1) to estimate the differences in clinical and economic outcomes between 2 groups of adult hospitalized patients with UTIs from E. coli resistant and susceptible bacteria and (2) to investigate drivers of this cost from a payer's perspective.<br />Methods: A prospective multicenter cohort study was conducted in 10 hospitals in Lebanon. The cost analysis followed a bottom-up microcosting approach; a linear regression was constructed to evaluate the predictors of hospitalization costs and a Cox proportional hazards model was used to estimate the impact of resistance on length of stay (LOS) and in-hospital mortality.<br />Results: Out of 467 inpatients, 250 cases were because of resistant E. coli isolates. Results showed that patients with resistant uropathogens had 29% higher mean total hospitalization costs ($3429 vs $2651; P = .004), and an extended median LOS (6 days vs 5 days; P = .020) compared with susceptible cohorts. The selection of resistant bacteria and the Charlson comorbidity index predicted higher total hospitalization costs and in-hospital mortality.<br />Conclusion: In an era of increased pressure for cost containment, this study showed the burden of treating UTIs resulting from resistant bacteria. The results can inform cost-effectiveness analyses that intend to evaluate the benefit of a national action plan aimed at decreasing the impact of antibiotic resistance.<br /> (Copyright © 2021. Published by Elsevier Inc.)
Details
- Language :
- English
- ISSN :
- 2212-1102
- Volume :
- 25
- Database :
- MEDLINE
- Journal :
- Value in health regional issues
- Publication Type :
- Academic Journal
- Accession number :
- 33852980
- Full Text :
- https://doi.org/10.1016/j.vhri.2021.03.001