Economic impact and formulary positioning of linezolid: a new anti-Gram-positive antimicrobial.
Gram-positive bacteria have emerged as major causes of colonization and serious infection within the nosocomial and increasingly also within the community setting. These infections have significantly contributed to patient morbidity and mortality as well as prolongation of hospital stay, a key determinant of the cost of an episode of infection in hospital. In many countries globally, infections due to methicillin-resistant Staphylococcus aureus (MRSA) are providing the greatest burden of clinical infection, often occurring in vulnerable patients or "high risk" therapeutic settings. Combined with this scenario is the increasing requirement for health care organizations to provide cost-effective health care as well as care that is delivered on evidence-based practice delivered through formularies or guidelines. This article aims to: 1) summarize the key economic considerations pertinent to these multiresistant infections but with an emphasis on MRSA, 2) discuss the current therapeutic options of managing MRSA infections, and 3) discuss the formulary positioning of linezolid by means of outlining its core strengths, weaknesses and the opportunity it provides to hospital infection management.
Nathwani
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Infection Ward, Tayside University Hospitals, Dundee, UK. nathwani@globalnet.co.uk
D000081:Acetamides / Q000191:economics* / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use; D002626:Chemistry, Pharmaceutical; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000188:drug therapy* / Q000517:prevention & control; D024881:Drug Resistance, Bacterial; D005572:Formularies, Hospital as Topic; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D017053:Infection Control / Q000592:standards*; D000069349:Linezolid; D016106:Methicillin Resistance; D023303:Oxazolidinones / Q000191:economics* / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D013211:Staphylococcus aureus; D014481:United States
D000081:Acetamides; D000900:Anti-Bacterial Agents; D023303:Oxazolidinones; D000069349:Linezolid