title: Pharmacoeconomics of piperacillin/tazobactam and imipenem/cilastatin in the treatment of patients with intra-abdominal infections.
abstract: Costs involved in using piperacillin 4 g/tazobactam 500 mg, given as intermittent intravenous infusions every 8 hours, were compared with those for imipenem/cilastatin 500 mg, given as intermittent intravenous infusions every 6 hours, for the treatment of patients with gangrenous or perforated appendicitis. A total of 88 patients were included in our cost analyses: 42 patients in the piperacillin/tazobactam group and 46 patients in the imipenem/cilastatin group. Durations (mean +/- SD) of antibiotic therapies were 7.8 +/- 3.3 days and 7.1 +/- 2.6 days for the piperacillin/tazobactam and imipenem/cilastatin groups, respectively. No statistical significance was found for the difference in duration of therapy (P = 0.376). Total drug treatment costs were $538.83 +/- $385.33 for the piperacillin/tazobactam group and $687.66 +/- $345.37 for the imipenem/cilastatin group. This difference in treatment cost was statistically significant (P = 0.0001). The need for laboratory tests and the use of other medications were not different between the two groups. Total hospital-days charges were higher for the piperacillin/tazobactam group ($18,339.76 +/- $6090.38) compared with the imipenem/cilastatin group ($16,150.00 +/- $5088.60) (P = 0.052). These findings suggest that length of hospital stay should be the economic focus of antibiotic therapy.
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy, University of Southern California, Los Angeles, USA.
authors.forename: S S
authors.initials: SS
authors.lastname: Jhee
authors.forename: M A
authors.initials: MA
authors.lastname: Gill
authors.forename: A E
authors.initials: AE
authors.lastname: Yellin
authors.forename: T V
authors.initials: TV
authors.lastname: Berne
authors.forename: P N
authors.initials: PN
authors.lastname: Heseltine
authors.forename: M D
authors.initials: MD
authors.lastname: Appleman
mesh_terms: D000328:Adult; D001064:Appendicitis / Q000188:drug therapy* / Q000191:economics / Q000601:surgery; D015377:Cilastatin / Q000191:economics / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D003627:Data Interpretation, Statistical; D003953:Diagnosis-Related Groups / Q000191:economics*; D005260:Female; D006801:Humans; D015378:Imipenem / Q000191:economics / Q000627:therapeutic use; D007262:Infusions, Intravenous; D007416:Intestinal Perforation / Q000188:drug therapy* / Q000191:economics / Q000601:surgery; D007902:Length of Stay; D008297:Male; D010397:Penicillanic Acid / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D010878:Piperacillin / Q000191:economics* / Q000627:therapeutic use; D012422:Rupture, Spontaneous; D012680:Sensitivity and Specificity; D000078142:Tazobactam
chemical_list: D015377:Cilastatin; D015378:Imipenem; D010397:Penicillanic Acid; D000078142:Tazobactam; D010878:Piperacillin