The cost of antibiotic therapy and antibiotic resistance for complicated intra-abdominal infections (cIAIs) and complicated urinary tract infections (cUTIs) in Italy

Il Costo Della Terapia Antibiotica e Dell'antibiotico-Resistenza Nelle Infezioni Intraddominali e Urinarie Complicate: l'esperienza di un Grande Presidio Ospedaliero Campano

Abstract

Objective To assess costs associated with the treatment of community-acquired cIAIs and cUTIs, from the Italian National Health Service perspective. Methods A retrospective observational cohort study was conducted. This study analyzed the charts of patients discharged from one Italian hospital between January 1 and December 31, 2015, with a primary diagnosis of community-acquired cIAIs or cUTIs. Patient characteristics, diagnosis, cost and length of antibiotic therapy, cost and length of hospital stay and antibiotic resistance were all recorded. Costs were calculated in Euros at 2015 values. Results The records of 324 patients (mean age 59.0 years; 48.8% males) were analyzed, 239 with cIAIs (mean age 59.9 years; males 53.2%) and 85 with cUTIs (mean age 56.5 years; males 38.8%). The average cost of care for a patient hospitalized due to cIAI was €8,519 (±€7,239) and due to cUTI was €3,866 (±€2,915). The average cost of the antibiotic therapy for a patient with cIAI was €503 (±€1,059) and with cUTI was €239 (±€526). Patients with antibiotic resistance received additional days of antibiotic therapy (cIAI: +9.5 days - p<0.0001; cUTI: +17.3 days - p<0.0001). Furthermore, they incurred in additional hospitalization costs (cIAI: €933 - p<0.0001; cUTI: €272 - p<0.0001). Conclusions These findings show that antibiotic resistance could increase the cost of care of community-acquired cIAIs or cUTIs.