Impact of initial antibiotic choice on clinical outcomes in XXXX : analysis of a hospital claims-made database.

@entity1 @entity2756 @entity2886 @entity2887 @entity497 @entity7187
BACKGROUND: Much controversy exists regarding the initial choice of antibiotics and selected outcomes for @entity1 with @entity497 ( @entity497 ). METHODS: The investigators analyzed a hospital claims-made database to assess the impact of initial antibiotic choice on 30-day mortality, total hospital costs, and hospital length of stay (LOS). Fine risk groups allowed for stratification for variations in the severity of illness. @entity1 were divided into five monotherapy groups (ie, @entity2756 , "other" @entity2886 , @entity2887 , @entity7187 , or penicillins) and four groups that received dual therapy (ie, the agents listed above, except @entity7187 ) plus @entity7187 . @entity1 also were stratified by age (ie, > 65 years of age and < 65 years of age). Severely ill @entity1 were excluded. RESULTS: Overall, 44,814 @entity1 met the criteria for inclusion. Among monotherapy @entity1 , those who received @entity7187 had the least mortality but were the least ill. @entity1 who received dual therapy generally had shorter LOSs, lower total hospital charges, and decreased mortality compared with those who received monotherapy. Differences among dual-therapy regimens regarding outcomes studies were noted. @entity1 who were < 65 years of age had lower mortality rates, shorter LOSs, and lower hospital charges than did the more elderly @entity1 . Within this group, those who received dual therapy had better outcomes than those who received monotherapy. CONCLUSIONS: We confirmed the value of dual therapy employing @entity7187 as a second agent in decreasing mortality from @entity497 , and we provided similar data regarding shorter LOSs and lower hospital charges. This appears to hold for a younger population. Differences among dual-therapy regimens (all employing @entity7187 ) appear to exist and may be clinically relevant.
