A cost-minimisation analysis comparing different antibiotic regimens used in treating all-cause bacterial pneumonia in Hong Kong.
BACKGROUND
To find out the antibiotic treatment regimens with the lowest cost for all-cause bacterial pneumonia, a study to compare the costs of different antibiotic regimens in the treatment of patients diagnosed with all-cause bacterial pneumonia who required hospitalisation was carried out.


METHODS
This was a multicentre, retrospective study of patient medical records. The primary aim was to examine whether the initial choice of antibiotic had affected the total cost of treatment, while the secondary aim was to find out whether the initial choice of antibiotic had affected the initial treatment failure rates and death rates. A cost-minimisation analysis (CMA) from a public hospital perspective was employed.


RESULTS
A total of 333 patient medical case notes were reviewed. The most commonly prescribed antibiotic regimen was amoxycillin-clavulanate (AC) followed by amoxycillin-clavulanate plus macrolide (ACM) and quinolone (Q). In the study population, no statistical significance could be detected between the mean cost of the three regimens. In the subgroup analysis of patients with a history of chronic obstructive pulmonary disease (COPD) and patients with a history of smoking, the Q regimen appeared to be the least expensive.


CONCLUSIONS
In the study population, no significant difference could be identified between the mean cost of the three antibiotic regimens. In a special populations such as patients with a history of COPD and patients with a history of smoking, the Q regimen appeared to be superior. Further studies in these areas are needed.
Lee
Kenneth K C
KK
School of Pharmacy, The Chinese University of Hong Kong, Shatin, Hong Kong, China. kclee@cuhk.edu.hk
Wan
Matthew H S
MH
Fan
Barry S K
BS
Chau
Michelle W Y
MW
Lee
Vivian W Y
VW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics*; D003363:Cost Control; D003362:Cost-Benefit Analysis; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000191:economics*; D012189:Retrospective Studies; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents