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Dec 1, 2016Article Details
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Main Article Content
Cost-effectiveness of ceftriaxone in the treatment of community-acquired pneumonia in adult hospital patients
Abstract
Objectives. A retrospective analysis was conducted to assess the cost-effectiveness of four intravenous antibiotic treatment regimens in the treatment of severe community-acquired pneumonia (CAP) in adults in a private hospital setting. The study compared some third-generation cephalosporin regimens with a second-generation cephalosporin and an amoxicillin/clavulanic acid (co-amoxiclav) regimen to investigate published South African treatment guidelines from a pharmacoeconomic point of view.
Method. A phanmaco-economic model of local costs, from a payer perspective, was based on the results of a meta-analysis of clinical papers from peer-reviewed journals. The study compared intravenous (IV) ceftriaxone (2 g once daily), cefotaxime (IV 2 g 3 times a day), cefuroxime (IV 750 mg 3 times a day, followed by 500 mg orally 3 times a day) and amoxicillin/clavulanic acid (IV 750 mg 3 times a day, followed by 625 mg orally 3 times a day).
Results. An analysis of the odds ratios (ORs) of all two-way comparisons indicated that ceftriaxone ensured significantly higher probabilities of successful outcomes than the other antibiotic treatment regimens (ORs in the order of two were indicated). The phanmaco-economic results suggested that the ceftriaxone treatment regimen was the most cost-effective in the hospital treatment of CAP in adult patients. These results proved to be robust across sensitivity analyses for success rates and treatment days. A sensitivity analysis testing the assumption that patients could be discharged once the oral treatment was initiated indicated that the amoxicillin/clavulanic acid and cefuroxime treatment arms were more cost-effective. The clinical validity of such an assumption is questionable.
Conclusion. Despite the conservative approach followed in terms of ceftriaxone data, both the clinical results and cost-effectiveness supported the use of ceftriaxone in the treatment of CAP in adults in the hospital setting.
