PARENTERAL ANTIBIOTIC USAGE PATTERNS AND EFFECTS OF INTRAVENOUS TO ORAL SWITCHING ON THE LENGTH AND COST OF HOSPITALIZATION
DOI:
https://doi.org/10.22159/ijap.2017.v9s1.44_50Keywords:
Switching antibiotics, Length of stay, CostAbstract
Objective: The prolonged use of intravenous antibiotics might increase the length and cost of hospitalization. The research objective, therefore, was to
evaluate the effect of switching antibiotics on the length of hospital stay and hospitalization cost. The prospective cohort research design was adopted.
The inclusion criteria were in patients who had received intravenous antibiotics.
Methods: The sample comprised 39 patients who switched antibiotics as an exposed group and 39 patients who did not switch as an unexposed
group. The data were collected using the patient medical records and the financial data from the hospital information system. The Mann–Whitney test
and Chi-square or Fisher's exact test was applied in the analysis.
Results: The results revealed that the antibiotics most commonly switched were intravenous ceftriaxone (83.3%) and oral cefixime (94.8%). From the
five switching patterns observed, the most common switch was from intravenous ceftriaxone to oral cefixime in patients with acute gastroenteritis.
All antibiotics were administered in accordance with the National Formulary (NF) guidelines. Only metronidazole (5 mg/ml dose) was inconsistent
with NF. Switching antibiotics did not impact the length of hospital stay and hospitalization cost; however, comorbidities did have an influence here.
Conclusions: Further, switching antibiotics impacted the duration over which intravenous antibiotics were administered and the cost of antibiotics.
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hospitalization and cost of treatment
Variables n Mean Standard
deviation
p
Length of
hospitalization (days)
Age
Adult 65 5.69~6 2.24 0.591
Elderly 13 5.92~6 2.18
BMI
Underweight 11 5.91~6 2.62 0.907
Not underweight 67 5.70~6 2.17
Comorbidity
Present 69 6.01~6 2.19 0.000
None 9 3.56~4 0.73
Payment methods
Assurance 63 5.95~6 2.29 0.052
Non‑assurance 15 4.80~5 1.66
Cost (rupiah)
Age
Adult 65 2621.780 1849.116 0.433
Elderly 13 2832.572 1408.100
BMI
Underweight 11 2806.242 1621.443 0.651
Not underweight 67 2632.396 1811.281
Comorbidity
Present 69 2874.471 1774.747 0.000
None 9 988.959 278.168
Payment methods
Assurance 63 2739.944 1679.054 0.109
Non‑assurance 15 2308.181 2172.142
BMI: Body mass index
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Variables n Mean Standard
deviation
p
Length (day)
Switching group 39 5.56~6 2.1 0.619
Non‑switching group 39 5.89~6 2.35
Cost (rupiah)
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Non‑switching group 39 2912.844 2113.276
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Payment status –1.099 –0.196 0.067
Cost
Antibiotic switching 66,6563.58 0.189 0.082 0.152
Comorbidity –2.011 –0.364 0.001
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active medical problems, and have a safe environment in which to continue
therapy [19]. Switching can also reduce the cost of antibiotics significantly
but does not reduce hospitalization costs. This is due to the presence of
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Table 10: The effects of switching against the length and cost of
using antibiotics among patients
Variables n Mean Standard
deviation
p
Duration (day)
Switching group 39 3.49 1.19 0.000
Non‑switching group 39 5.67 2.33
Cost (rupiah)
Switching group 39 46.478 51.947 0.003
Non‑switching group 39 114.781 169.660
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