title: Ceftriaxone is twice as cost-effective as standard therapy in biliary tract infection.
abstract: OBJECTIVE
  Various antibiotics, mainly cephalosporins and broad-spectrum penicillins, are indicated in biliary tract infection. The primary endpoint was to compare the cost-effectiveness of ceftriaxone (Rocephin) 1 g once daily vs. standard therapy two or three times daily.
  
  
  METHODS
  A prospective multicenter observational study, matched-pair analysis of 902 patients receiving ceftriaxone or standard therapy (second-generation cephalosporin, broad-spectrum penicillin or a combination of aminopenicillin and beta-lactamase inhibitor) in 75 hospitals yielded 173 pairs matched for definite risk criteria. Both groups received comparable accompanying endoscopic antiobstructive treatment. Cost parameters included primary antibiotic purchase, total antibiotic purchase (including combination and second-line drugs), and infusion preparation and administration.
  
  
  RESULTS
  87.9% of patients in the ceftriaxone group vs. 73.4% in the standard group received antibacterial monotherapy, for 7.5 vs. 9.1 days respectively (p=0.001). Therapy was equally effective in both groups. Overall treatment costs, including antibiotic purchase and infusion preparation/administration, were 170.84 vs. 320.46, respectively (p=0.0001).
  
  
  CONCLUSIONS
  Ceftriaxone 1 g once daily is approximately twice as cost-effective as standard therapy in biliary tract infection: lower concomitant medication costs, a shorter treatment course, and lower antibiotic administration costs achieved an approximate 50% saving.
authors.affiliation: Medical Department C, Klinikum Ludwigshafen gGmbH, Germany. thomas.zoepf@uni-essen.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Zoepf
authors.forename: Ralf
authors.initials: R
authors.lastname: Jakobs
authors.forename: Juergen F
authors.initials: JF
authors.lastname: Riemann
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D001660:Biliary Tract Diseases / Q000188:drug therapy*; D002443:Ceftriaxone / Q000191:economics* / Q000627:therapeutic use*; D002511:Cephalosporins / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D011446:Prospective Studies; D065093:beta-Lactamase Inhibitors
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D010406:Penicillins; D065093:beta-Lactamase Inhibitors; D002443:Ceftriaxone