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

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

	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

Note: PCN = penicillin, ERY = erythromycin, FQ = fluoroquinolone. “Resistant” includes intermediate and non-susceptible isolates. Post-2008 MIC breakpoints were used for penicillin resistance.
*All hospitalizations due to resistance were the result of failed therapy for patients treated initially in the outpatient setting.
** Hospitalizations include admissions from the emergency department.
*** All costs are expressed in 2012 dollars. Direct medical costs exclude work and productivity loss.

ISSN: 2047-2994