Comparative cost effectiveness of gentamicin and tobramycin.
Gentamicin and tobramycin were compared for cost effectiveness in the treatment of adult patients with serious infections in a general medical service. We used data from a randomized double-blind trial in which the only observed difference between the clinical effects of these aminoglycosides was the incidence of nephrotoxicity (26% with gentamicin and 12% with tobramycin). According to 1984 cost data, the combined average drug and nephrotoxicity costs per patient were $127 for tobramycin and $72 for gentamicin. An extensive sensitivity analysis--varying frequency and cost of nephrotoxicity, dialysis requirements, aminoglycoside acquisition costs, and length of hospitalization--showed gentamicin to be more cost effective than tobramycin, unless hospitalization is prolonged by an average of at least 15 days for patients with severe nephrotoxicity or at least 3 days for all patients with moderate or severe nephrotoxicity.
D000328:Adult; D001424:Bacterial Infections / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D004311:Double-Blind Method; D005839:Gentamicins / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000191:economics / Q000628:therapy; D007902:Length of Stay / Q000191:economics; D010607:Pharmacy Service, Hospital / Q000191:economics; D011682:Purchasing, Hospital / Q000191:economics; D011897:Random Allocation; D006435:Renal Dialysis / Q000191:economics; D014031:Tobramycin / Q000009:adverse effects / Q000627:therapeutic use*
D005839:Gentamicins; D014031:Tobramycin