Details:

Alternative Title:
Antimicrob Resist Infect Control
Personal Author:
Reynolds, Courtney A ; Finkelstein, Jonathan A ; Ray, G Thomas ; Moore, Matthew R ; Huang, Susan S
Reynolds, Courtney A ; Finkelstein, Jonathan A ; Ray, G Thomas ; Moore, Matthew R ; Huang, Susan S Less -
Description:
Background

The burden of disease due to S. pneumoniae (pneumococcus), particularly pneumonia, remains high despite the widespread use of vaccines. Drug resistant strains complicate clinical treatment and may increase costs. We estimated the annual burden and incremental costs attributable to antibiotic resistance in pneumococcal pneumonia.

Methods

We derived estimates of healthcare utilization and cost (in 2012 dollars) attributable to penicillin, erythromycin and fluoroquinolone resistance by taking the estimate of disease burden from a previously described decision tree model of pneumococcal pneumonia in the U.S. We analyzed model outputs assuming only the existence of susceptible strains and calculating the resulting differences in cost and utilization. We modeled the cost of resistance from delayed resolution of illness and the resulting additional health services.

Results

Our model estimated that non-susceptibility to penicillin, erythromycin and fluoroquinolones directly caused 32,398 additional outpatient visits and 19,336 hospitalizations for pneumococcal pneumonia. The incremental cost of antibiotic resistance was estimated to account for 4% ($91 million) of direct medical costs and 5% ($233 million) of total costs including work and productivity loss. Most of the incremental medical cost ($82 million) was related to hospitalizations resulting from erythromycin non-susceptibility. Among patients under age 18 years, erythromycin non-susceptibility was estimated to cause 17% of hospitalizations for pneumonia and $38 million in costs, or 39% of pneumococcal pneumonia costs attributable to resistance.

Conclusions

We estimate that antibiotic resistance in pneumococcal pneumonia leads to substantial healthcare utilization and cost, with more than one-third driven by macrolide resistance in children. With 5% of total pneumococcal costs directly attributable to resistance, strategies to reduce antibiotic resistance or improve antibiotic selection could lead to substantial savings.


Subjects:
[+]
Antibiotic Resistance DRSP Healthcare Utilization Research Streptococcus Pneumoniae
Source:
Antimicrob Resist Infect Control. 2014; 3:16.
Document Type:
Journal Article
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:511dde828b424aa520afe02ff0b2098d171eb9a84ea5d97b63c9fc8bda81320c
Download URL:
https://stacks.cdc.gov/view/cdc/27301/cdc_27301_DS1.pdf
File Type:

Supporting Files

• 	2047-2994-3-16-1.gif	gif
  	2047-2994-3-16-1.jpg	jpeg
  	2047-2994-3-16.nxml	txt
  	license.txt	txt

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