title: A simple cost-saving measure: 2.5% mafenide acetate solution.
abstract: The optimal concentration of mafenide acetate solution for use in the treatment of burns is unknown. Despite data supporting the use of a 2.5% solution, 5% formulation is traditionally used, and has been the highest-costing medication on formulary. The aim of the current study is to evaluate cost and patient outcomes associated with a new policy implementing the use of 2.5% solution in burn patients and restricting the 5% formulation to specific indications only. A retrospective review of all patients receiving mafenide acetate solution at a single pediatric burn hospital was performed before and after the initiation of the new policy on the use of 5 vs 2.5% solution. Duration of therapy, adverse events, cost, incidence of wound infection, and bacteremia were analyzed. In 2009, 69 patients were treated with 5% mafenide acetate solution for a total cost of $125,000 ($1811 per patient). In 2010, after the initiation of the policy, 48 patients were treated: 19 received 5% mafenide acetate solution with appropriate indication, whereas the remaining 29 received 2.5% solution for a total cost of $38,632 ($804 per patient). There were no significant changes in the incidence of bacteremia or wound infection. No side effects of either solution were noted. Under certain conditions, a 2.5% mafenide acetate solution appears sufficient. In this multinational pediatric burn hospital, the use of a 2.5% solution was not associated with increased bacteremia or wound infection, and proved to be more cost-effective.
authors.affiliation: From the *Department of Surgery, Division of Burns, Massachusetts General Hospital, and Shriners Hospital, Boston; and †Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Amir
authors.initials: A
authors.lastname: Ibrahim
authors.forename: Shawn
authors.initials: S
authors.lastname: Fagan
authors.forename: Tim
authors.initials: T
authors.lastname: Keaney
authors.forename: Karim A
authors.initials: KA
authors.lastname: Sarhane
authors.forename: Derek A
authors.initials: DA
authors.lastname: Hursey
authors.forename: Philip
authors.initials: P
authors.lastname: Chang
authors.forename: Rob
authors.initials: R
authors.lastname: Sheridan
authors.forename: Colleen
authors.initials: C
authors.lastname: Ryan
authors.forename: Ronald
authors.initials: R
authors.lastname: Tompkins
authors.forename: Jeremy
authors.initials: J
authors.lastname: Goverman
mesh_terms: D000293:Adolescent; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage* / Q000191:economics; D016470:Bacteremia / Q000453:epidemiology / Q000517:prevention & control; D002056:Burns / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D017046:Cost Savings; D006801:Humans; D007223:Infant; D008272:Mafenide / Q000008:administration & dosage* / Q000191:economics; D012189:Retrospective Studies; D014946:Wound Infection / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D000891:Anti-Infective Agents, Local; D008272:Mafenide
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