BACKGROUND: Treatment adherence and persistence are crucial to achieve glycemic control in patients with type 2 diabetes (T2D). Early response to a new therapy may lead to improved treatment adherence and associated outcomes.

Aim To compare healthcare resource use and costs between newly diagnosed multiple myeloma (NDMM) patients with and without skeletal-related events (SREs). Methods Adults newly diagnosed with MM (1 January 2006 and 30 June 2017) with at least 12 months continuous health coverage prior to diagnosis were identified using the IBM MarketScan administrative claims. To control for baseline differences, NDMM patients with SREs were propensity score matched to NDMM patients without SREs. Outcomes included annual HRU and costs during follow-up along with number and type of SREs (SRE cohort only). Patients with SREs were stratified by number of SREs, and annual SRE-related costs were reported. Student's t test and Chi-squared test were used to compare outcomes. Results Before matching, the 6648 patients in the SRE cohort had more comorbidities, were more likely to have MM treatment, and had higher pre-index healthcare costs than the 7458 patients in the non-SRE cohort. After matching, cohorts of 3432 patients were well balanced on baseline characteristics. Patients with SREs (vs. without SREs) had significantly higher inpatient, outpatient, and pharmacy HRU. Patients with SREs had significantly higher mean annual all-cause healthcare costs ($213,361 vs. $94,896, p < 0.001) with hospitalization being the leading driver of increased costs (38.7% of total). Among 6648 patients with SREs, the mean annual SRE-related healthcare costs were $39,603, $45,463, and $50,111 for patients with one, two, and three or more events, respectively. Conclusions NDMM patients with SREs have more than twice the all-cause healthcare costs than matched patients without SREs. Costs increase with the number of SRE events.

Context: Antibiotic treatment duration for bloodstream infections (BSIs) is an area of controversy and uncertainty. Aims: Our objective was to assess antibiotic treatment duration practices for critically ill patients with BSIs in Kuwait. Subjects and Methods: A survey consisting of clinical scenarios followed by questions about recommended antibiotic treatment duration for each scenario was sent to Kuwaiti infectious diseases, critical care specialists, and anesthetists with critical care experience. Statistical Analysis Used: Descriptive analysis (medians and interquartile ranges) and Kruskal–Wallis test were used for statistical analysis. Results: The survey response rate was 68% (112/164). The median (interquartile range [IQR]) ranges for antibiotic duration recommendations were similar for each bacteremic syndrome: central line-associated BSIs, 10 days (7–14); pneumonia, 10 days (7–14); urinary tract infection, 10 days (7–14); intra-abdominal infection, 10 days (7–14); and skin and soft-tissue infection, 10 days (7–14). The median (IQR) antibiotic durations for the following bacteria were as follows: Staphylococcus aureus, 14 days (10–14); extended-spectrum beta-lactamase Escherichia coli, 10 days (7–14); multidrug-resistant (MDR) Pseudomonas aeruginosa, 14 days (10–14); MDR Acinetobacter baumannii, 14 days (10–14); vancomycin-resistant Enterococcus faecalis, 14 days (10–14); carbapenem-resistant Klebsiella pneumoniae, 14 days (10–14); and coagulase-negative Staphylococcus, 7 days (7–10). For all infectious syndromes and individual organisms, duration responses often followed discrete choices of 5, 7, 10, and 14 days. Prolonging antibiotic therapy for immunocompromised patients was favored among 70% of respondents. Conclusions: This survey demonstrates practice variation in treating BSIs and supports the need for adequately powered randomized controlled trials assessing optimal antibiotic duration for various bacteremic syndromes, pathogens, and resistance patterns.

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