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Antimicrobial use varies widely across pediatric hospitals
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Hospital use of antimicrobial medications varies between different patient populations, while hospital costs are affected by a small number of specific antimicrobial therapies, according to a recent study.
“Medications account for more than 10% of health care spending, and antimicrobials are consistently among the medication classes with the most expenditures in U.S. hospitals,” Jason G. Newland, MD, MEd, division of infectious diseases, Children’s Mercy Hospitals and Clinics, and colleagues wrote. “Both the volume and choice of antimicrobials used, however, vary substantially across centers.”
The researchers analyzed the volume of antimicrobial use by drug, class, and clinical condition at 36 pediatric hospitals. All data used were from patients discharged in 2012 and gathered from the Pediatric Health Information System.
Of the 599,518 patients discharged from the pediatric hospitals in 2012, 59.6% received some type of antimicrobial therapy. The researchers said this use highlights that antimicrobial medications account for a substantial portion of hospital spending, with a cost of $192.9 million, or 17.1% of the total hospital pharmacy budget.
Antibacterials accounted for 72.5% of the cost and 81.8% of days of therapy. The five most expensive antimicrobials were vancomycin, meropenem, pipercillin-tazobactam, amphotericin B-lipid and ceftriaxone. Collectively, they accounted for 35% of costs spent on antimicrobials.
Pediatric patients treated for bone marrow transplant (10.7%), cystic fibrosis exacerbation (7.3%), and neonatal care (6.8%) were responsible for the largest amount of antimicrobial spending. However, neonatal care had one of the lowest cost vs. days of therapy ratios reported.
The most expensive antimicrobials differed among pediatric hospitals, whereas in adult-dominated hospitals the most costly antimicrobial is daptomycin.
The researchers suggested that antimicrobial stewardship programs and the promotion of judicious use of antimicrobials would help to reduce hospital expenditures.
“Antimicrobials account for a large proportion of medication spending in children’s hospitals and cost varies substantially,” Newland and colleagues wrote. “Antimicrobial stewardship programs should collect and consider cost data to help optimize antimicrobial prescribing strategies.” – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
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