While the cost of antibiotic treatment for Enterobacteriaceae infections was a small component of total costs, each extra day of inadequate antibiotic treatment added $750-plus to hospital costs, according to a study published in Antimicrobial Resistance & Infection Control.
Researchers conducted a retrospective cohort study using the Premier Research database of 175 U.S. hospitals. They included adult patients admitted with a culture-confirmed urinary tract infection, pneumonia or sepsis as principal diagnosis, or as a secondary diagnosis in the setting of respiratory failure. Enterobacteriaceae are common pathogens in pneumonia, sepsis and UTIs.
They defined inappropriate antimicrobial coverage as "failure to administer an antibiotic therapy in vitro active against the culture-confirmed pathogen within 2 days of admission."
Among the 40,137 patients with Enterobacteriaceae infections who were studied, 4,984 received inappropriate antimicrobial coverage. CRE was more frequent in patients given inappropriate treatment than patients who received appropriate empiric therapy.
The proportions of total costs represented by antibiotics were similar in inappropriate treatment and appropriate empiric therapy groups. However, each additional day of inadequate therapy cost an additional $766 as compared to adequate treatment.