Cost analysis of a sequential antimicrobial therapy protocol in patients with pneumonia: A multicenter study
Abstract
Pneumonia is one of the leading causes of hospitalization and mortality due to infectious diseases and is also responsible for a substantial proportion of antimicrobial prescriptions. This study aimed to analyze the clinical outcomes and the economic implications associated with a sequential antimicrobial in hospitalized patients with pneumonia. This was a multicenter, retrospective, observational cost analysis study conducted in four private Brazilian hospitals between January 2022 and December 2023. A total of 185 medical records from patients undergoing the sequential therapy protocol were included. Clinical outcomes, length of hospital stay, acceptability among physicians of pharmacist-led interventions for switching the route of administration, and the direct costs related to medications and human resources were assessed according to a microcosting methodology. Among the included patients, 74.6% transitioned to the oral route, and 88.4% showed a positive clinical outcome. Sequential therapy was associated with a significant reduction in mean length of stay (10.1 vs. 14.7 days; p = 0.024) and was associated with 55% lower treatment costs, corresponding to an estimated cost avoidance of US$ 4,529.96. The findings suggest that sequential antimicrobial therapy is an safe and economically advantageous strategy that contributes to the rational use of antimicrobials and the optimization of hospital resources.
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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