Journal Article

Clinical and Economic Outcomes of Conventional Amphotericin B-Associated Nephrotoxicity

Stephan Harbarth, John P. Burke, James F. Lloyd, R. Scott Evans, Stanley L. Pestotnik and Matthew H. Samore

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 35, issue 12, pages e120-e127
Published in print December 2002 | ISSN: 1058-4838
Published online December 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/344468
Clinical and Economic Outcomes of Conventional Amphotericin B-Associated Nephrotoxicity

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A retrospective 9-year cohort study was conducted to identify the hospitalization costs, length of hospital stay, and mortality associated with nephrotoxicity (NT) among 494 inpatients who were treated with conventional amphotericin B (CAB). Survival regression methods were used to model the effect of NT. The rate of NT was 12%; the overall in-hospital mortality rate was 22%. After adjustment for confounding, NT was associated with a 2.7-fold higher risk of death (P <.001). Although the unadjusted effects of NT on length of hospital stay and hospitalization costs after the initiation of CAB were consistent with small increases, such effects were not significant in multivariate models (time ratio, 1.2 [P =.2]; cost ratio, 1.1 [P =.8]). The greater the number of days before the onset of NT that were included in the analysis, the greater the apparent effect of NT on costs. CAB-associated NT was associated with increased mortality, but it did not impact the costs and length of hospital stay.

Journal Article.  4547 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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