Cefotaxime vs nafcillin and tobramycin for the treatment of serious infection. Comparative cost-effectiveness.
To evaluate the cost-effectiveness of cefotaxime sodium at a dosage of 12 g/day vs nafcillin sodium and tobramycin sulfate for the treatment of serious infection, the hospital and physician charges of patients enrolled in a prospective, randomized, clinical trial were analyzed. For 187 patients receiving therapy empirically, mean hospital charges for the interval in which the trial antibiotics were used were $3,550 +/- $1,740 for cefotaxime and $3,160 +/- $1,990 for nafcillin and tobramycin. After adjusting for cost-generating factors, charges for cefotaxime were greater than for nafcillin and tobramycin, but the difference was not significant. For 107 patients with clinically or bacteriologically documented infection, mean charges were $3,980 +/- $1,800 for cefotaxime and $4,170 +/- $1,780 for nafcillin and tobramycin. Adjusted charges did not differ. Incremental charges for cefotaxime per additional response were $1,630 in all patients and -$820 in patients with clinically or bacteriologically documented infections.
D001424:Bacterial Infections / Q000188:drug therapy* / Q000191:economics; D002439:Cefotaxime / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic / Q000191:economics; D003362:Cost-Benefit Analysis; D004311:Double-Blind Method; D005249:Fees and Charges; D006801:Humans; D007668:Kidney / Q000187:drug effects; D008396:Maryland; D009254:Nafcillin / Q000009:adverse effects / Q000627:therapeutic use*; D011897:Random Allocation; D012044:Regression Analysis; D013997:Time Factors; D014031:Tobramycin / Q000009:adverse effects / Q000627:therapeutic use*
D009254:Nafcillin; D002439:Cefotaxime; D014031:Tobramycin