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Relationship between the appropriateness of antibiotic treatment and clinical outcomes/medical costs of patients with community-acquired acute pyelonephritis: a multicenter prospective cohort study

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Author(s)
Choseok YoonSe Yoon ParkBongyoung KimKi Tae KwonSeong-yeol RyuSeong-Heon WieHyun-uk JoJieun KimKyung-Wook HongHye In KimHyun ah KimMi-Hee KimMi-Hyun BaeYong-Hak SohnJieun KimYangsoon LeeHyunjoo Pai
Keimyung Author(s)
Ryu, Seong YeolKim, Hyun Ah
Department
Dept. of Internal Medicine (내과학)
Journal Title
BMC Infect Dis
Issued Date
2022
Volume
22
Keyword
Acute pyelonephritisUrinary tract infectionAntibioticsKorea
Abstract
Background:
Inappropriate use of antibiotics not only increases antibiotic resistance as collateral damage but also increases clinical failure rates and medical costs. The purpose of this study was to determine the relationship between the appropriateness of antibiotic prescription and outcomes of community-acquired acute pyelonephritis (CA-APN).

Methods:
A multicenter prospective cohort study was conducted at eight hospitals in Korea between September 2017 and August 2018. All hospitalized patients aged ≥ 19 years who were diagnosed with CA-APN on admission were recruited. The appropriateness of empirical and definitive antibiotics, as well as the appropriateness of antibiotic treatment duration and route of administration, was evaluated in accordance with the guideline and expert opinions. Clinical outcomes and medical costs were compared between patients who were administered antibiotics ‘appropriately’ and ‘inappropriately.’

Results:
A total of 397 and 318 patients were eligible for the analysis of the appropriateness of empirical and definitive antibiotics, respectively. Of them, 10 (2.5%) and 18 (5.7%) were administered ‘inappropriately’ empirical and definitive antibiotics, respectively. Of the 119 patients whose use of both empirical and definitive antibiotics was classified as ‘optimal,’ 57 (47.9%) received antibiotics over a longer duration than that recommended; 67 (56.3%) did not change to oral antibiotics on day 7 of hospitalization, even after stabilization of the clinical symptoms. Patients who were administered empirical antibiotics ‘appropriately’ had shorter hospitalization days (8 vs. 10 days, P = 0.001) and lower medical costs (2381.9 vs. 3235.9 USD, P = 0.002) than those who were administered them ‘inappropriately.’ Similar findings were observed for patients administered both empirical and definitive antibiotics ‘appropriately’ and those administered either empirical or definitive antibiotics ‘inappropriately’.

Conclusions:
Appropriate use of antibiotics leads to better outcomes, including reduced hospitalization duration and medical costs.
Keimyung Author(s)(Kor)
류성열
김현아
Publisher
School of Medicine (의과대학)
Citation
Choseok Yoon et al. (2022). Relationship between the appropriateness of antibiotic treatment and clinical outcomes/medical costs of patients with community-acquired acute pyelonephritis: a multicenter prospective cohort study. BMC Infect Dis, 22, 112. doi: 10.1186/s12879-022-07097-9
Type
Article
ISSN
1471-2334
Source
https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07097-9
DOI
10.1186/s12879-022-07097-9
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44172
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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