Background and importance Ceftolozane–tazobactam (CT) intravenous infusion using portable elastomeric infusion pumps (EIP) is useful, especially in patients infected with resistant bacteria.
Aim and objectives The aim of the study was to describe CT infusion using EIP (CT-EIP) and analyse the healthcare costs avoided versus hospital admission.
Material and methods This retrospective study included all patients treated with CT-EIP. The study period was January 2017 to October 2019. Recorded data were clinical data obtained from patient electronic medical records. For the economic evaluation we considered costs of the EIP, nurse working time needed for preparation and cost of the hospital at home care unit (HHU). The cost of the medication was not included as it was the same whether the patient was in hospital or at home. Physician and pharmacist working time was not analysed as it was considered that hospital admission and management by the HHU were equivalent.
For the calculation of hospital admission costs, the regional normative was considered: a day at the HHU costs €80.70, and the cost per hospital admission day is €528.95. Nursing work needed for preparation of the EIP costs €15.81/hour (a nurse prepares an average of 10 EIP/hour).
Baxter Healthcare Corporation manufactured the EIP used: 24 hour duration devices (240 mL/24 hours, flow rate 10 mL/hour) for continuous perfusion or 30 min duration devices (100 mL/30 min, flow rate 200 mL/hour) for intermittent perfusions.
The unit cost of EIP was €25.63 for the 240 mL/24 hour devices (needed 1/day) and €15.40 for the 100 mL/30 min one (needed 3/day). Average cost per day of treatment with CT-EIP were €35.91 (range €25.63–46.20/day).
Results A total of 220 CT-EIP were prepared for 10 patients (5 men, 5 women; mean age 58.1 years (range 19–90 years) with hospital acquired pneumonia (6), off-label situations (2), severe abdominal infection (1) and severe urinary infection (1). Microorganisms isolated were Pseudomonas aeruginosa (10/10 patients); Staphylococcus aureus (2/10); and Escherichia coli (1/10). Eight of 10 patients were treated with concomitant antibiotic. Treatment took an average of 13 days (range 7–29) per patient with CT-EIP.
Seven of 10 patients were managed by HHU and the rest had ambulatory care after hospital discharge. Successful progression occurred in five patients. Five patients died due to other severe pathologies (cancer, cystic fibrosis, acute rejection, etc).
The avoided estimated cost was €55 856.26.
Conclusion and relevance CT-EIP was a cost effective alternative, which enabled patients to stay at home, avoiding unnecessary hospital admission and improving their quality of life.
References and/or acknowledgements No conflict of interest.
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