What is the Cost of Nephrotoxicity Associated with Aminoglycosides?

Abstract

We measured the economic impact of aminoglycoside-associated nephrotoxicity in a nested case-control study at six Philadelphia area hospitals. From the charts of 1756 patients who received aminoglycosides and met entry criteria, we collected data on patient demographics, clinical characteristics, and resource utilization for all patients with nephrotoxicity and for a sample of patients without nephrotoxicity. Of the 1756 patients, 129 (7.3%) developed aminoglycoside-associated nephrotoxicity. The component costs of nephrotoxicity were calculated by hospital accounting methods; room and board costs were enumerated with per diem rates. The additional cost of hospital ancillary services per case of nephrotoxicity was $446 (p < 0.001); the additional cost of hospital stay was $825 for additional routine days (2.74 days) (p < 0.02) and $1152 for intensive care days (1.50 days) (p < 0.001). Additional consultations were $78 per patient. Therefore, the mean total additional cost of aminoglycoside-associated nephrotoxicity was $2501. The average additional cost per patient receiving aminoglycosides was $183.