[Cost-effectiveness of the treatment of acute and chronic rhinosinusitis at the IMSS].
BACKGROUND
Rhinosinusitis is one of the more common diseases encountered in outpatient visits to health care. The objective of this study was to determine the most cost-effective antibiotic treatment for patients with acute (RSA) and chronic rhinosinusitis (RSC) that is available at the Mexican Institute of Social Security (IMSS).


METHODS
Cost-effectiveness analysis of RSA and RSC treatment from an institutional perspective. Effectiveness outcome was defined as the percentage of cure. A decision tree with a Bayesian approach included the following therapeutic alternatives: ciprofloxacin, gatifloxacin, trimetoprim/sulfametoxazol (TMP/SMX), amoxicilin/clavulanic acid (AAC) and clindamicin.


RESULTS
Treatment for RSA with AAC showed a mean cost per cured patient of $ 878 pesos. The remaining antibiotics had a higher cost per unit of success, and therefore the results showed that AAC was the best alternative considering this criterion. The therapy that showed a larger percentage of cured patients in RSC was clindamicin; however, the therapeutic alternative with the lowest cost per successful unit was the one based on ciprofloxacin, which dominates gatifloxacin and AAC.


CONCLUSIONS
The most cost-effective alternative in the antibiotic treatment of patients with RSA was ACC while for RSC it was ciprofloxacin; sensitivity analysis showed the strength of the base study results.
Muñoz-Carlin
María de Lourdes
Mde L
Servicio de Otorrinolaringología, Hospital General Regional No. 72 "Lic. Vicente Santos Guajardo", IMSS, México, DF.
Nevárez-Sida
Armando
A
García-Contreras
Fernando
F
Mendieta-Sevilla
Sergio Raymundo
SR
Constantino-Casas
Patricia
P
D000208:Acute Disease; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D002908:Chronic Disease; D002939:Ciprofloxacin / Q000191:economics / Q000627:therapeutic use; D002981:Clindamycin / Q000008:administration & dosage / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D016527:Drug Costs; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000627:therapeutic use; D000077734:Gatifloxacin; D006801:Humans; D008800:Mexico / Q000453:epidemiology; D012220:Rhinitis / Q000188:drug therapy* / Q000453:epidemiology; D012852:Sinusitis / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D002981:Clindamycin; D002939:Ciprofloxacin; D019980:Amoxicillin-Potassium Clavulanate Combination; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D000077734:Gatifloxacin