PMID- 28064542
OWN - NLM
STAT- MEDLINE
DCOM- 20170213
LR  - 20181202
IS  - 2154-8331 (Print)
IS  - 2154-8331 (Linking)
VI  - 45
IP  - 1
DP  - 2017 Feb
TI  - Antibiotic treatment patterns, costs, and resource utilization among patients 
      with community acquired pneumonia: a US cohort study.
PG  - 1-8
LID - 10.1080/21548331.2017.1279012 [doi]
AB  - OBJECTIVES: The current treatment options for patients with community-acquired 
      pneumonia (CAP) often present a trade-off between the potential for treatment 
      failure and safety concerns. We set out to investigate real-world outcomes 
      associated with the use of currently available antimicrobial treatment options 
      for CAP in both the outpatient and inpatient (non-intensive care unit [ICU]) 
      settings. METHODS: This claims-based retrospective study included adult patients 
      diagnosed with CAP and treated with antibiotic therapies, including any oral 
      fluoroquinolone, macrolide, or beta-lactam monotherapy in the outpatient setting, 
      and intravenous (IV) levofloxacin or IV azithromycin/ceftriaxone in the inpatient 
      setting. Generalized linear model (GLM) regression was used to determine total 
      charges for inpatient stay, the length of stay, and days of inpatient therapy. 
      For outpatients, rates of adverse events (AEs), treatment failure, and 
      hospitalization were compared by type of initial antibiotic therapy using 
      logistic regression multivariate models that controlled for baseline 
      characteristics. RESULTS: A total of 441,820 outpatients and 33,287 inpatients 
      treated for CAP between 2007 and 2012 were included in this analysis. In the 
      outpatient setting, fluoroquinolone therapy led to a higher rate of documented 
      AEs (adjusted odds ratio [OR]: 1.23; 95% confidence interval [CI]: 1.20-1.25; 
      p < 0.0001) but a lower rate of retreatment (adjusted OR: 0.9; 95% CI: 0.87-0.94; 
      p < 0.0001) compared with macrolides. Both AEs and retreatment in these patients 
      were associated with increased costs. For patients treated with the IV 
      macrolide/beta-lactam combination compared with IV fluoroquinolone in the 
      inpatient setting, a significantly longer length of stay in hospital (4.71 vs. 
      4.38 days; p < 0.0001) and greater overall costs ($3,535 more per stay; 
      p < 0.0001) were observed. CONCLUSION: In both the inpatient and outpatient 
      settings, the development of additional efficacious treatment options that have a 
      reduced AE burden for patients with CAP may be warranted.
FAU - Llop, Christopher J
AU  - Llop CJ
AD  - a Analysis Group, Inc. , Boston , MA , USA.
FAU - Tuttle, Edward
AU  - Tuttle E
AD  - b Analysis Group, Inc. , Menlo Park , CA , USA.
FAU - Tillotson, Glenn S
AU  - Tillotson GS
AD  - c Department of Medical Affairs , Cempra Pharmaceuticals , Chapel Hill , NC , 
      USA.
FAU - LaPlante, Kerry
AU  - LaPlante K
AD  - d Pharmacy , The University of Rhode Island, College of Pharmacy , Kingston , RI 
      , USA.
FAU - File, Thomas M Jr
AU  - File TM Jr
AD  - e Infectious Disease Division , Summa Health , Akron , OH , USA.
LA  - eng
PT  - Journal Article
DEP - 20170118
PL  - England
TA  - Hosp Pract (1995)
JT  - Hospital practice (1995)
JID - 101268948
RN  - 0 (Anti-Bacterial Agents)
RN  - 75J73V1629 (Ceftriaxone)
RN  - 83905-01-5 (Azithromycin)
RN  - A4P49JAZ9H (Ofloxacin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Ambulatory Care/*economics/statistics & numerical data
MH  - Anti-Bacterial Agents/economics/*therapeutic use
MH  - Azithromycin/therapeutic use
MH  - Ceftriaxone/therapeutic use
MH  - Community-Acquired Infections/*drug therapy/*economics
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Ofloxacin/therapeutic use
MH  - Pneumonia, Bacterial/*drug therapy/*economics
MH  - Retrospective Studies
MH  - Risk Assessment
OTO - NOTNLM
OT  - Community-acquired pneumonia
OT  - antibiotics
OT  - beta-lactams
OT  - fluoroquinolones
OT  - inpatients
OT  - macrolides
OT  - outpatients
EDAT- 2017/01/10 06:00
MHDA- 2017/02/14 06:00
CRDT- 2017/01/10 06:00
PHST- 2017/01/10 06:00 [pubmed]
PHST- 2017/02/14 06:00 [medline]
PHST- 2017/01/10 06:00 [entrez]
AID - 10.1080/21548331.2017.1279012 [doi]
PST - ppublish
SO  - Hosp Pract (1995). 2017 Feb;45(1):1-8. doi: 10.1080/21548331.2017.1279012. Epub 
      2017 Jan 18.