Clinical and financial impact of intravenous erythromycin therapy in hospitalized patients

OBJECTIVE: TO determine the economic consequences of intravenous erythromyc in use in hospital patients in a variety of clinical circumstances. DESIGN: Retrospective cohort study of patients with specified primary diagn osis-related group discharge diagnoses treated from January 1, 1990, to Dec ember 31, 1994, who received erythromycin, and a matched cohort group from the same period who did not receive erythromycin. SETTING: LDS Hospital, Salt Lake City, UT, a 520-bed teaching hospital. PATIENTS: A long-term archive of clinical and financial data from a compute rized hospital information system was searched for patients meeting a stric t case definition. This archive contained information on erythromycin expos ure as well as concurrent drug therapy and adverse drug events that had bee n prospectively evaluated during hospitalization throughout the study and c ohort periods. Detailed costs were available for each patient. MAIN OUTCOME MEASURE: Attributable differences in lengths of stay and total costs determined using linear regression modeling. RESULTS: For 797 erythromycin patients and 2771 cohort patients, we found a n attributable increased length of stay of 2.14 days and an increased cost of hospitalization of $6061 for erythromycin case patients. Case patients a lso had a significantly increased risk of adverse drug events. Linear regre ssion modeling showed that erythromycin use was significantly related to in creased length of stay and cost of hospitalization. CONCLUSIONS: Intravenous erythromycin use has been associated with signific ant increases in hospital length of stay and total hospital cost.