{"title":"Evaluating Antibiotics Misuse and Cost Analysis among Hospitalized Dengue Virus Infected Adults: Insights from a Retrospective Cohort Study","authors":"Thundon Ngamprasertchai, Ashley Siribhadra, Chayanis Kositamongkol, Pittaya Piroonamornpun, Piyanan Pakdeewut, Viravarn Luvira, Saranath Lawpoolsri, Pinyo Rattanaumpawan","doi":"10.1093/ofid/ofae520","DOIUrl":null,"url":null,"abstract":"Background Dengue is a prevalent cause of acute febrile illness, predominantly in Asia, where it necessitates supportive care without the need for antibiotics. This study aims to evaluate antibiotics usage and analyze the hospitalization costs among adults infected with the dengue virus. Methods This retrospective cohort study was conducted at the Hospital for Tropical Diseases, Thailand, in 2022. Two independent reviewers assessed all adult cases with confirmed dengue from 2016 to 2021. Determinants of inappropriateness were analyzed using Poisson regression. Results The study included 249 participants with over half presenting with severe dengue or dengue with warning signs upon admission. The cumulative incidence of antibiotics use was 9.3% (95% confidence interval [CI]: 8.23–10.47), predominantly involving empirical treatment strategies. Ceftriaxone and doxycycline were the most frequently prescribed antibiotics. Notably, patients who received empirical antibiotics showed no definite or presumed bacterial infections. Among those who received definite strategies, inappropriate durations, including both short treatments and the overuse of broad-spectrum antibiotics, were observed. A private ward admission was identified as a significant predictor of inappropriate use, with an incidence rate ratio of 4.15 (95% CI: 1.16–14.82) compared to ICU admission. Direct medical costs did not differ significantly between appropriate and inappropriate uses. Conclusions The incidence of antibiotic use among dengue cases was moderate; however, inappropriate use by indications were mainly observed. Antimicrobial Stewardship (AMS) strategies should be encouraged, particularly in dengue with warning signs, admitted to general or private ward. Direct medical costs between appropriate and inappropriate uses were comparable.","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.8000,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Forum Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ofid/ofae520","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background Dengue is a prevalent cause of acute febrile illness, predominantly in Asia, where it necessitates supportive care without the need for antibiotics. This study aims to evaluate antibiotics usage and analyze the hospitalization costs among adults infected with the dengue virus. Methods This retrospective cohort study was conducted at the Hospital for Tropical Diseases, Thailand, in 2022. Two independent reviewers assessed all adult cases with confirmed dengue from 2016 to 2021. Determinants of inappropriateness were analyzed using Poisson regression. Results The study included 249 participants with over half presenting with severe dengue or dengue with warning signs upon admission. The cumulative incidence of antibiotics use was 9.3% (95% confidence interval [CI]: 8.23–10.47), predominantly involving empirical treatment strategies. Ceftriaxone and doxycycline were the most frequently prescribed antibiotics. Notably, patients who received empirical antibiotics showed no definite or presumed bacterial infections. Among those who received definite strategies, inappropriate durations, including both short treatments and the overuse of broad-spectrum antibiotics, were observed. A private ward admission was identified as a significant predictor of inappropriate use, with an incidence rate ratio of 4.15 (95% CI: 1.16–14.82) compared to ICU admission. Direct medical costs did not differ significantly between appropriate and inappropriate uses. Conclusions The incidence of antibiotic use among dengue cases was moderate; however, inappropriate use by indications were mainly observed. Antimicrobial Stewardship (AMS) strategies should be encouraged, particularly in dengue with warning signs, admitted to general or private ward. Direct medical costs between appropriate and inappropriate uses were comparable.
期刊介绍:
Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.