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IV Antimicrobial Therapy in the Inpatient and Ambulatory Settings

Researchers report that the prevalence of adverse events in patients treated with intravenous antibacterial therapy was similar in the inpatient and ambulatory settings, and costs were substantially lower outside the hospital. “These findings should inform efforts to expand” the use of antibacterial therapy in ambulatory patients, the authors conclude.

The retrospective observational cohort study used population-based linked data from British Columbia to determine infection types during hospital stays and implied durations of IV antimicrobial therapy in the inpatient and outpatient settings. Based on outcomes of cumulative adverse events and direct healthcare costs over a 90-day outcome interval, the investigators found adverse events in statistically similar percentages of 1,842 patients: 35.6% of ambulatory patients and 39.0% of hospitalized patients. Hospital readmissions were more common in the ambulatory group (30.5% vs. 23.0%), but occurring less often were Clostridioides difficile diarrhea (1.2% vs 3.1%) and death (2.0% vs 8.8%). Estimated healthcare costs were significantly different: $30,166 for ambulatory patients and $50,038 for hospitalized patients. Cost savings in the ambulatory setting averaged $17,579.

Source: Clinical Infectious Diseases