title: A cost-effectiveness analysis of antibiotic therapy in macrolide-resistant community-acquired pneumonia.
abstract: Successful treatment of community-acquired pneumonia (CAP) can have substantial implications. As rates of antibiotic resistance of Streptococcus pneumoniae--the most common pathogen of CAP-increase, so does the likelihood that first-line pharmacotherapy will fail. Thus, the cost effectiveness and budgetary effects of treating CAP with amoxicillin/ clavulanate (AMX/CLA) extended-release (ER) and clarithromycin ER were analyzed. The model considers incidence of macrolide and AMX/ CLA-susceptible and nonsusceptible S. pneumoniae in empiric therapy. Clinical cure rates from multicenter clinical trials and published literature were used to calculate average treatment costs and success. Amoxicillin/ clavulanate ER resulted in a higher percentage of patients cured compared with clarithromycin ER (88.7% vs. 82.4%, respectively) and lower average per-patient treatment costs (dollar 437.70 vs. dollar 548.14, respectively).
authors.affiliation: Health Economics of RTI Health Solutions, Research Triangle Park, North Carolina 27709, USA. searnshaw@rti.org
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Earnshaw
authors.forename: Sean D
authors.initials: SD
authors.lastname: Candrilli
authors.forename: Ancilla W
authors.initials: AW
authors.lastname: Fernandes
authors.forename: Mitchell K
authors.initials: MK
authors.lastname: Higashi
mesh_terms: D017714:Community-Acquired Infections / Q000188:drug therapy*; D003362:Cost-Benefit Analysis; D004351:Drug Resistance; D006801:Humans; D018942:Macrolides / Q000627:therapeutic use*; D013296:Streptococcus pneumoniae / Q000472:pathogenicity
chemical_list: D018942:Macrolides