A pharmacoeconomic model to evaluate antibiotic costs.
OBJECTIVE
To characterize patient sociodemographics and health, describe vancomycin treatment parameters and clinician-rated outcomes, and determine costs associated with treatment including preparation and administration, adverse events, and toxicity.


METHODS
A prospective study to develop a model for costs associated with antibiotic treatment (vancomycin).


METHODS
A community hospital.


METHODS
One hundred adults with active infections.


METHODS
Mean duration of therapy was 10 days, and most patients received 2000 mg/day. Serum concentrations were monitored in two of three patients. Detailed cost analyses were completed on a subset of 26 patients selected at random from the overall sample.


RESULTS
Sepsis and skin and skin structure infections were the most common indications for vancomycin therapy. Treatment was effective in 81 patients, failed in 9, and was not evaluable in 10. Thirty-eight percent of patients experienced adverse events attributable to the drug. Phlebitis was common, and red man syndrome, nephrotoxicity, and ototoxicity were infrequent.


CONCLUSIONS
Total cost of vancomycin treatment for 100 patients was $30,251: $23,855 for preparation and administration, $1710 for monitoring serum concentrations, and $4686 for treating adverse reactions. Drug costs accounted for only 55% of the total cost. Vancomycin is safe and effective, but phlebitis is underreported and significantly affects cost.
Garrelts
J C
JC
St. Francis Research Institute, Wichita, KS 67214-2878.
Horst
W D
WD
Silkey
B
B
Gagnon
S
S
D000328:Adult; D001424:Bacterial Infections / Q000188:drug therapy / Q000191:economics; D003710:Demography; D016527:Drug Costs / Q000706:statistics & numerical data*; D017723:Drug Utilization Review / Q000191:economics*; D005069:Evaluation Studies as Topic; D005260:Female; D006764:Hospitals, Community / Q000191:economics; D006801:Humans; D008297:Male; D018803:Models, Economic; D010607:Pharmacy Service, Hospital / Q000191:economics*; D011446:Prospective Studies; D017192:Skin Diseases, Bacterial / Q000188:drug therapy / Q000191:economics; D014640:Vancomycin / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use
D014640:Vancomycin