Hospitalizations With Antibiotic-Resistant Infections on the Rise

In response to Dr. Mainous’s suggestion that insurance coverage is associated with hospital length of stay, I do not think that lack of insurance is leading to premature discharge. One reason that LOS for antibiotic-resistant infections is getting shorter may be that our ability to provide home therapies – such as IV antibiotics, which we typically end up giving when antibiotic resistance is found – was available in 2006, but not in 1997.

In addition, the skilled inpatient facility was not available in 1997 to the extent that it is today, so many patients who simply need IV antibiotics to treat resistant infections may be discharged to receive care elsewhere. It is not as if their care is ending.

The criteria for discharge are the same between resistant and nonresistant infections. Furthermore, there is nothing in this study to suggest that those patients who presented with resistant infections were more ill than those patients with infections involving antibiotic-susceptible organisms.

Franklin Michota, M.D., is the director of academic affairs in the department of hospital medicine at the Cleveland Clinic.