Inan Dilara, Saba Rabin, Gunseren Filiz, Ongut Gozde, Turhan Ozge, Yalcin Ata Nevzat, Mamikoglu Latife
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
BMC Infect Dis. 2005 Jan 31;5:5. doi: 10.1186/1471-2334-5-5.
Many studies associated nosocomial infections with increased hospital costs due to extra days in hospital, staff time, extra investigations and drug treatment. The cost of antibiotic treatment for these infections represents a significant part of hospital expenditure. This prospective observational study was designed to determine the daily antibiotic cost of nosocomial infections per infected adult patient in Akdeniz University Hospital.
All adult patients admitted to the ICUs between January 1, 2000, and June 30, 2003 who had only one nosocomial infection during their stay were included in the study. Infection sites and pathogens, antimicrobial treatment of patient and it's cost were recorded. Daily antibiotic costs were calculated per infected patient.
Among the 8460 study patients, 817 (16.6%) developed 1407 episodes of nosocomial infection. Two hundred thirty three (2.7%) presented with only one nosocomial infection. Mean daily antibiotic cost was 89.64 dollars. Daily antibiotic cost was 99.02 dollars for pneumonia, 94.32 dollars for bloodstream infection, 94.31 dollars for surgical site infection, 52.37 dollars for urinary tract infection, and 162.35 dollars for the other infections per patient. The treatment of Pseudomonas aeruginosa infections was the most expensive infection treated. Piperacillin-tazobactam and amikacin were the most prescribed antibiotics, and meropenem was the most expensive drug for treatment of the nosocomial infections in the ICU.
Daily antibiotic cost of nosocomial infections is an important part of extra costs that should be reduced providing rational antibiotic usage in hospitals.
许多研究表明,医院感染会因住院天数增加、医护人员工作时间、额外检查及药物治疗等因素导致医院成本上升。这些感染的抗生素治疗费用占医院支出的很大一部分。本前瞻性观察性研究旨在确定阿克德尼兹大学医院每位成年感染患者医院感染的每日抗生素成本。
纳入2000年1月1日至2003年6月30日期间入住重症监护病房(ICU)且住院期间仅发生一次医院感染的所有成年患者。记录感染部位和病原体、患者的抗菌治疗及其费用。计算每位感染患者的每日抗生素成本。
在8460例研究患者中,817例(16.6%)发生了1407次医院感染。233例(2.7%)仅发生一次医院感染。每日抗生素平均成本为89.64美元。每位患者肺炎的每日抗生素成本为99.02美元,血流感染为94.32美元,手术部位感染为94.31美元,尿路感染为52.37美元,其他感染为162.35美元。铜绿假单胞菌感染的治疗是最昂贵的感染治疗。哌拉西林-他唑巴坦和阿米卡星是最常用的抗生素,美罗培南是ICU中治疗医院感染最昂贵的药物。
医院感染的每日抗生素成本是额外成本的重要组成部分,应通过在医院合理使用抗生素来降低。