Major ArticleThe economic burden of methicillin-resistant Staphylococcus aureus in community-onset pneumonia inpatients

•This study quantified the burden of community-onset MRSA pneumonia inpatients.•Hospitalization costs of the MRSA group were 1.7 times that of the control group.•The strengths of this study were the large sample size and detailed risk adjustments.

BackgroundThe quantitative effect of multidrug-resistant bacterial infections on real-world health care resources is not clear. This study aimed to estimate the burden of methicillin-resistant Staphylococcus aureus (MRSA) infections in pneumonia inpatients in Japan.MethodsUsing a nationwide administrative claims database, we analyzed pneumonia patients who had been hospitalized in 1,063 acute care hospitals. Patients who received anti-MRSA drugs were categorized into an anti-MRSA drug group, and the remaining patients comprised the control group. We estimated the burden of length of stay, in-hospital mortality, total antibiotic agent costs, and total hospitalization costs. Risk adjustments were conducted using propensity score matching.ResultsThe study sample comprised 634 patients administered anti-MRSA drugs and 87,427 control patients. In propensity score-matching analysis (1 to 1), the median length of stay, antibiotic costs, and hospitalization costs of the anti-MRSA drug group were significantly higher than those of the control group (21 days vs 14 days [P < .001], $756 vs $172 [P < .001] and $8,741 vs $5,063 [P < .001], respectively); the attributable excess of these indicators were 9.0 ± 1.6 days, $1,044 ± $101, and $5,548 ± $580, respectively.ConclusionsThese findings may serve as a reference to support further research on multidrug-resistant bacterial infections and eventually inform policy formulation.