A cost too high to bear? Prophylaxis versus preemptive therapy to prevent post-transplantation cytomegalovirus.
Both prophylaxis and preemptive therapy are used to prevent the development of cytomegalovirus (CMV) disease after transplantation. Preemptive therapy exposes the least number of patients to costly and potentially toxic drugs. Prophylaxis is less labor intensive and requires less expensive monitoring. While the overall cost of the two modalities is similar, current literature suggests that prophylaxis has an advantage in avoiding secondary effects of CMV. Randomized comparative trials are imperative.
Pescovitz
M D
MD
Indiana University Medical Center, Department of Surgery, Indianapolis, Indiana 46202, USA. mpescov@iupui.edu
D000998:Antiviral Agents / Q000008:administration & dosage* / Q000191:economics; D003362:Cost-Benefit Analysis; D003587:Cytomegalovirus; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000191:economics* / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D015774:Ganciclovir / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use; D006801:Humans; D007674:Kidney Diseases / Q000188:drug therapy / Q000517:prevention & control / Q000821:virology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D000077562:Valganciclovir
D000998:Antiviral Agents; D000077562:Valganciclovir; D015774:Ganciclovir