Healthcare resource utilization and costs associated with inadequate initial antibiotic treatment of bacteraemia produced by carbapenem-resistant Gram-negative bacilli (CRGNB): a descriptive, observational study in Spanish hospitals.

INTRODUCTION

Carbapenem-resistant gram-negative bacilli (CRGNB) are one of the main causes of nosocomial infections, posing a major public health challenge. Blood stream infections (BSI) require special attention because of the higher morbidity and mortality associated.

OBJECTIVE

To assess the impact of initial adequate or inadequate antibiotic treatment on the length of stay (LOS) and healthcare resource utilisation of patients with bloodstream infections (BSI) caused by a Carbapenem-resistant gram-negative bacilli (CRGNB) in the Spanish clinical practice.

METHODS

A descriptive, observational, retrospective chart review study of patients diagnosed with CRGNB bacteriemia in 6 Spanish public hospitals.

RESULTS

The overall median LOS of the total population (n=64) was 26.5 days (Q1: 16 days; Q3: 40 days). The median LOS for the initially adequately treated group was 27 days (Q1: 17; Q3: 50), and 24 days (Q1: 15; Q3: 38) for the initially inadequately treated (t-test p= 0.5031). In the Hospital Ward group (n=44), initially adequately treated patients spent hospitalised a median of 6 days less than the initially inadequately treated patients (18 days [Q1: 12; Q3: 27] vs 24 days [Q1: 15; Q3: 38] respectively, p=0.0269). In the total population analysis, initially adequately treated patients had a lower use of resources (20,895.02 [Q1: 11,543.67 ; Q3: 61,773.17 ]) compared to initially inadequately treated patients (24,444.02 [Q1: 11,571.63 ; Q3: 40,790.64 ).

CONCLUSION

Results suggest that inadequate empirical treatment for BSI caused by CRGNB in the hospital ward could be associated with an increase in the LOS and resource utilization of these patients.