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Table 3 Estimated annual healthcare utilization attributable to antibiotic resistant strains of pneumococcus for all ages*

From: Attributable healthcare utilization and cost of pneumoniae due to drug-resistant Streptococcus pneumoniae: a cost analysis

  Children (age <18) Adults (age ≥18) Total (all ages)
Attributable to PCN resistance    
  Hospitalizations** 867 471 1,338
  Outpatient visits 1,478 780 2,258
  Direct medical costs*** 3,023,332 2,864,498 5,887,829
  Total costs 5,358,139 8,916,750 14,274,155
Attributable to ERY resistance    
  Hospitalizations 9,711 7,889 17,600
  Outpatient visits 16,557 12,933 29,490
  Direct medical costs 35,443,768 47,185,234 82,629,002
  Total costs 68,096,627 143,766,210 211,862,838
Attributable to FQ resistance    
  Hospitalizations 0 399 399
  Outpatient visits 0 650 650
  Direct medical costs 0 2,425,796 2,425,796
  Total costs 0 6,935,208 6,935,208
Attributable to PCN, ERY, or FQ resistance    
  Hospitalizations 10,578 8,758 19,336
  Outpatient visits 18,035 14,363 32,398
  Direct medical costs 38,467,099 52,475,527 90,942,627
  Total costs 73,454,767 159,617,433 233,072,201
All cases (susceptible and resistant)    
  Hospitalizations 57,158 344,124 401,282
  Outpatient visits 435,967 729,334 1,165,301
  Direct medical costs 265,374,908 2,295,429,821 2,560,804,729
  Total costs 555,738,333 4,407,889,411 4,963,627,745
  1. Note: PCN = penicillin, ERY = erythromycin, FQ = fluoroquinolone. “Resistant” includes intermediate and non-susceptible isolates. Post-2008 MIC breakpoints were used for penicillin resistance.
  2. *All hospitalizations due to resistance were the result of failed therapy for patients treated initially in the outpatient setting.
  3. ** Hospitalizations include admissions from the emergency department.
  4. *** All costs are expressed in 2012 dollars. Direct medical costs exclude work and productivity loss.