Cost-effectiveness of ceftazidime by continuous infusion versus intermittent infusion for nosocomial pneumonia.
OBJECTIVE
To determine if continuous-infusion ceftazidime is more cost-effective and efficacious than intermittent infusion in patients with nosocomial pneumonia.


METHODS
Prospective, open-label, randomized trial.


METHODS
Large, community teaching hospital.


METHODS
Intensive care unit (ICU) patients with nosocomial pneumonia.


METHODS
Ceftazidime 3 g/day was administered as a continuous infusion or as 2 g 3 times/day by intermittent infusion to treat nosocomial pneumonia in the ICU. Patients also received tobramycin 7 mg/kg once/day.


RESULTS
Thirty-five patients were evaluable; 17 received continuous infusion and 18 intermittent infusion. Clinical efficacy (94% and 83% successful outcomes with continuous and intermittent infusion, respectively), adverse events, and length of stay did not vary significantly between groups. Costs associated with continuous infusion, $627 +/- 388, were significantly lower (p < or = 0.001) than with intermittent infusion, $1007 +/- 430.


CONCLUSIONS
Continuous infusion of ceftazidime is a cost-effective alternative to intermittent infusion for nosocomial pneumonia in the ICU.
McNabb
J J
JJ
Department of Pharmacy, Hartford Hospital, Connecticut, USA.
Nightingale
C H
CH
Quintiliani
R
R
Nicolau
D P
DP
D000328:Adult; D000368:Aged; D002442:Ceftazidime / Q000008:administration & dosage* / Q000191:economics*; D002511:Cephalosporins / Q000008:administration & dosage* / Q000191:economics*; D003362:Cost-Benefit Analysis / Q000191:economics / Q000379:methods; D003428:Cross Infection / Q000188:drug therapy / Q000191:economics*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous / Q000379:methods; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy / Q000191:economics*; D011446:Prospective Studies; D016896:Treatment Outcome
D002511:Cephalosporins; D002442:Ceftazidime