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KMID : 0869619970140020144
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Journal of Korean Society of Hospital Pharmacists
1997 Volume.14 No. 2 p.144 ~ p.152
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A Study on the Cost of the Antibiotic Therapy against Acute Pyelonephritis
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유영인/You, Y.I.
안혜원/김주휘/윤덕심/황광서/Ahn, H.W./KIm, J.H./Yoon, D.S./Hwang, K.S.
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Abstract
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In order to evaluate the cost of hospitalization for anti-infective therapy against acute pyelonephrites(APN), we performed a retrospective study on the therapeutic regimens for the patients(pt) diagnosed and admitted to a 600-bed teaching hospital in Korea. The regimen of each pt was compared to the published guidelines of ten areas on initiation, selection, and follow-up. All comparisons were performed with t-test and the level of significance was set at p<0.05. Among 170 APN pts treated between 1992 and 1994, 112pts(65.9％) were analyzed excluding pts with either complications, immunosuppression or age less than 18months old. 99pts(88.4％) were female with 53pts (female 47) between 21-40years old in agreement with the reports that pts with APN were predominantly female younger than 50y.o. Therapeutic regimen in 45pts(40.2％) was completely in agreement with all ten areas of the guidelines, 66pts (58.9％) in more than 9 areas and 96pts(85.7％) in more than 8 areas. Frequently ignored areas were usage of aminoglycosides(65.1％), antibiotic therapy duration(27.6％), and transition to an appropriate oral antibiotic agent(22.9％). Most interestingly, pt´s hospital stay was extened significantly by 1.2days (20％, p<0.05), when any area of guidelines was not observed. Therefore, violation of guidelines raised the cost of all the drugs by 32.9％(11.9％/day), and that of antibiotic, by 38.6％(16.6％/day). Inclusion of the admixture service fee of \748 IM or \904 for IV blunted the differeneces. Our analysis clearly shows that the appropriate antibiotic use suitable to criteria reduced cost of treating APN including hospitalization period. Furthermore, since the total cost of the therapy is dependent on that of the labor others, rising rapidly in the developing countries, a further evaluation is required for the successful pharmaceutical care.
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