Current guidelines recommend a wide range of first-line single or multiple antimicrobial regimens based on patient characteristics PF-02341066 datasheet (comorbidities,

immunosuppression, and previous antibiotic exposure), expected involved pathogens (inferred by source and origin, community or hospital-acquired, of infection) and local resistance epidemiology [1, 5] . Most recent guidelines also consider the antibiotic treatment of cIAIs from a microbiological point of view, particularly in terms of pathogens producing ESBLs (Extended Spectrum Beta-Lactamases). For community-acquired extrabiliary cIAIs, empirical antimicrobial therapy can be divided into categories: treatment for critically ill and non-critically ill patients, and treatment for both groups according to the presence or absence of risk factors for ESBL-producing pathogens. In non-critically ill patients, amoxicillin-clavulanate or ciprofloxacin-metronidazole are possible options, but in the presence of risk factors for ESBL these are not sufficient, and other drugs such as tigecycline and ertapenem are useful. In critically ill patients without risk factors for ESBL, piperacillin-tazobactam is an option, but in the presence of ESBL risk factors carbapenems

like imipenem and meropenem are more appropriate [9]. Of note, knowledge of antibiotic drugs costs is suggested as additional criteria supporting clinical decision-making [1, 5, 9]. In fact, selleck in some US and European studies, a significant influence of empiric antibiotic therapy choice on economic outcome of cIAIs has emerged [3, 6, 7, 10]. Pritelivir However, the wide inter-country variability of antimicrobial prescribing attitudes and of health care and reimbursement systems organization could differently impact on cost estimates. Therefore, due to this limited generalizability of data, referring to pharmacoeconomic analyses from other countries could be misleading. To the best of our knowledge, a costs analysis of cIAIs hospital

care has never been performed in Italy, although IAIs have been ranked as the second most common infectious reason for hospitalization, after respiratory infections [11]. To address this issue, this study aimed to assess the costs associated with the treatment of community-acquired Metalloexopeptidase cIAIs, from the Italian National Health Service (i.e. the third payer) perspective. Methods Study design This one-year, multicentre, retrospective, incidence-based observational study was performed in four Italian (Bari, Florence, Turin, and Verona) acute-care university hospitals. The study was conducted in accordance with the ethical principles of the Declaration of Helsinki (and subsequent revisions) and to the current norm for observational studies. The protocol was reviewed and approved by each study site’s ethical committees. Due to the retrospective study design, informed consent was not deemed necessary.