title: Pharmacoeconomic comparison of sequential IV/oral ciprofloxacin versus ceftazidime in the treatment of nosocomial pneumonia.
abstract: A retrospective, cost-effectiveness analysis was performed on 106 clinically evaluable patients who participated in a multi-centre, randomized study of sequential IV/oral ciprofloxacin therapy versus ceftazidime for the treatment of nosocomial pneumonia. Although nearly half of the ciprofloxacin patients received sequential therapy, the majority were treated with a full IV regimen. Clinical success rates and antibiotic-related adverse events were similar for the ciprofloxacin and ceftazidime groups. Per patient and per day costs of antibiotic acquisition; preparation and administration; treatment of adverse events, and clinical failures were compared. Decision analysis revealed that ciprofloxacin therapy was cost-effective compared to ceftazidime 2 g q8h. Varying the probability of clinical success between 60-99% failed to change the economic decision; costs for ciprofloxacin were always lower than for ceftazidime. Further sensitivity analyses demonstrated that if the ceftazidime price was reduced by 50% (equivalent to 1 g q8h), treatment costs would be similar to ciprofloxacin therapy. Increasing the ciprofloxacin price by 50% (equivalent to a q8h frequency) produced per patient costs similar to ceftazidime, although ciprofloxacin therapy retained a lower cost per day (p < 0.0002). For the treatment of nosocomial pneumonia, ciprofloxacin therapy was cost-effective compared to ceftazidime.
authors.affiliation: School of Pharmacy, University of New York at Buffalo, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Paladino
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000191:economics*; D002170:Canada; D002442:Ceftazidime / Q000008:administration & dosage / Q000191:economics*; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000191:economics*; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000188:drug therapy*; D016527:Drug Costs; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010607:Pharmacy Service, Hospital / Q000191:economics; D011014:Pneumonia / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome