title: Cost-effectiveness of oral gemifloxacin versus intravenous ceftriaxone followed by oral cefuroxime with/without a macrolide for the treatment of hospitalized patients with community-acquired pneumonia.
abstract: We studied the cost-effectiveness of oral gemifloxacin with intravenous ceftriaxone followed by oral cefuroxime with or without a macrolide to treat patients hospitalized with community-acquired pneumonia. Data were prospectively collected as part of a randomized multicenter study. The costs evaluated included antimicrobial acquisition (1st level); plus preparation, dispensing, and administration costs, and treatment of antimicrobial-related adverse events and clinical failures (2nd level); plus per diem costs for hospital stay related to study drug administration (3rd level). At follow-up, clinical success was similar between gemifloxacin (76.9%)- and ceftriaxone (79.1%)-treated patients. The median 1st-level costs for gemifloxacin and ceftriaxone were $136 and $470 (P<0.001), respectively. For the 2nd level, these costs were $158 and $542 (P<0.001), and for the 3rd level, these were $5052 and $5789 (P=0.025), respectively. The median cost per expected success was $6568 for gemifloxacin and $7321 for ceftriaxone (P=0.29). Oral gemifloxacin is clinically effective and has an economic advantage over ceftriaxone, followed by oral cefuroxime with or without a macrolide.
authors: Institute for Clinical Pharmacodynamics, Ordway Research Institute, Albany, NY 12208, USA. sbhavnani-icpd@ordwayresearch.org
authors: Sujata M
authors: SM
authors: Bhavnani
authors: Paul G
authors: PG
authors: Ambrose
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D002443:Ceftriaxone / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D002444:Cefuroxime / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000188:drug therapy; D003362:Cost-Benefit Analysis; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D000077735:Gemifloxacin; D006801:Humans; D018942:Macrolides / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009287:Naphthyridines / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D011014:Pneumonia / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D018942:Macrolides; D009287:Naphthyridines; D002443:Ceftriaxone; D002444:Cefuroxime; D000077735:Gemifloxacin