[Cost-effectiveness analysis of ceftriaxone and cefotaxime in the treatment of community-acquired pneumonia].
OBJECTIVE
To assess the cost-effectiveness ratio of ceftriaxone and cefotaxime to treat moderate to severe community acquired pneumonia (CAP).


METHODS
A clinical trial was done in five hospitals of the Instituto Mexicano del Seguro Social, at the metropolitan area of Mexico City. Ceftriaxone and cefotaxime were compared to treat moderate to severe CAP, and the costs of purchasing, preparation, administration, hospitalization, and therapeutic success were quantified. Cost-effectiveness ratio was calculated, and sensitivity analysis and incremental analysis were done.


RESULTS
The main isolated germs were Streptococcus pneumoniae (23.6%) and Staphylococcus aureus (18.5%). Most of the microorganisms were sensitive to ceftriaxone, ceftazidime, and cefotaxime, and were resistant to penicillin, ampicillin, and erythromycin. Therapeutic success was 98% in the ceftriaxone group and 83% in the cefotaxime group (p = 0.0091). Cost-effectiveness ratio for per cent unit of success was $19,458.62 Mexican pesos in the ceftriaxone group and $29,218.08 in the cefotaxime group. Sensitivity analysis showed consistently a lower cost-effectiveness ratio in the ceftriaxone group. Incremental analysis based on the treatment of 55 patients showed that using ceftriaxone instead of cefotaxime resulted in saving $35,170.79 per each additional cured patient.


CONCLUSIONS
Ceftriaxone has a lower cost-effectiveness ratio than cefotaxime to treat patients with CAP and bad prognosis criteria requiring hospitalization.
García-Contreras
F
F
Hospital General de Zona 2-A Francisco del Paso y Troncoso. dantea@cim.spin.com.mx
Del-Angel-García
G
G
Ramírez Cuenca
A
A
Malváez-Valdes
M
M
Vega Yáñez
A
A
Amato
D
D
D002439:Cefotaxime / Q000191:economics* / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000191:economics* / Q000627:therapeutic use*; D002511:Cephalosporins / Q000191:economics* / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000188:drug therapy*; D012680:Sensitivity and Specificity
D002511:Cephalosporins; D002443:Ceftriaxone; D002439:Cefotaxime