Antifungal management and resource use in patients with acute myeloid leukaemia after chemotherapy : retrospective analysis of changes over 3 yr in a German hospital

  • Objectives: To describe changes in costs of managing hospitalised patients with acute myeloid leukaemia (AML) after chemotherapy in Germany over 3 yr, with a special focus on prophylaxis and treatment patterns as well as resource use related to invasive fungal infections (IFI). Methods: The study was conducted as a retrospective, single-centre chart review in patients with AML hospitalised for chemotherapy, neutropenia and infections after myelosuppressive chemotherapy from January 2004 to December 2006 in Germany. The following resource utilisation data were collected: inpatient stay, mechanical ventilation, parenteral feeding, diagnostics, systemic antifungal medication and cost-intensive concomitant medication. Direct medical costs were calculated from hospital provider perspective. Results: A total of 471 episodes in 212 patients were included in the analysis. Occurrence of IFI decreased from 5.9% in 2004 to 1.9% in 2006. Mean (± standard deviation) hospital stay decreased from 28.7 ± 17.9 d in 2004 to 22.4 ± 11.8 d in 2006. From 2004 to 2006, the use of a single antifungal drug increased from 30.4% to 46.9%, whereas the use of multiple antifungal drugs decreased from 24.4% to 13.1%. The use of liposomal amphotericin B declined between 2004 and 2006 (21.4% vs. 3.8%) and caspofungin between 2005 and 2006 (19.3% vs. 8.1%). Total costs per episode declined from €19051 ± 19024 in 2004 to €13531 ± 9260 in 2006; major reductions were observed in the use of antimycotics and blood products as well as length of hospital stay. Conclusion: Analysis of real-life data from one single centre in Germany demonstrated a change in antifungal management of patients with AML between 2004/2005 and 2006, accompanied by a decline in total costs.

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Author:Angelika Böhme, Johannes Atta, Sabine Mousset, Birgit Ehlken, Margarita Shlaen, Gesine BugORCiDGND, Hubert ServeORCiDGND, Dieter HoelzerGND
Pubmed Id:
Parent Title (English):European journal of haematology
Place of publication:Oxford
Document Type:Article
Date of Publication (online):2014/06/17
Date of first Publication:2013/12/12
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2014/06/17
Tag:acute myeloid leukaemia; antifungal management; antifungal prophylaxis; chemotherapy; costs; posaconazole
Page Number:10
First Page:68
Last Page:77
Copyright © 2011 John Wiley & Sons A/S Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2.5, which does not permit commercial exploitation.
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung-Nicht kommerziell 3.0