burnetii, causing a relatively milder course of the disease and a significant shorter duration of hospital stay, being identified as an independent cost limiting factor in the multivariable model. In the present study, costs of medication represented a very small part of the total costs of hospitalisation. This means that policies aiming at selleck catalog an early intravenous to oral switch of antimicrobial treatment will not result in substantial cost savings by reducing drug expenses. costs might be reduced if the switch resulted in earlier hospital discharge. Medication costs for pneumonia Inhibitors,Modulators,Libraries caused by Legionella pneumophila appeared significantly higher compared to other aetiological groups. This is most likely caused by a higher ICU admission rate for these pneumonias and linked to the use of specific Inhibitors,Modulators,Libraries drugs such as fresh frozen plasma and sedatives.
This study has several strengths. First, we were able to identify the causative pathogen in a large number of patients enabling comparisons between aetiological groups. Second, we analysed resource utilization on an individual patient level. Third, data of two hospitals were studied Inhibitors,Modulators,Libraries adding to the external validity of the findings. Besides this, the characteristics of the patients studied resemble data from another large nationwide CAP cohort from the Netherlands further adding to the generalisability of the findings. There are also limitations that need to be addressed. First, due to missing data in some resources categories, not all 505 patients could be included in the overall cost analyses.
This was due to being unable to retrieve Inhibitors,Modulators,Libraries some resource use from the years 2004 until 2006. We consider, however, that this has no impact on the validity of the findings because the more recent years are fully included, making the total costs of hospitalisation representative for the present standard of care for CAP. A further reassuring factor is that the comparison of patient characteristics and clinical outcomes of the 361 patients included in the analyses with the 144 patients not included, showed no large differences. However, the lower number of patients available for analysis resulted in some aetiological subgroups becoming rather small. Another limitation is that patients directly admitted to the ICU were absent in the study cohorts used. In the most recent cohort, 25 of the 817 eligible patients were not included due to direct ICU admission.
This phenomenon could have lead to an underestimation of the absolute costs of hospitalisation for CAP. However, Inhibitors,Modulators,Libraries given this low percentage, we expect this effect to be rather small. Furthermore, it is very unlikely to have biased the relative costs per pathogen. Finally, we cannot rule out that the costs related to microbiology exams are overestimated. We studied patients who had participated in clinical studies in which a large panel of microbiological Nutlin-3a 675576-98-4 tests had been performed to maximize pathogen identification.