title: Nosocomial pneumonia caused by methicillin-resistant Staphylococcus aureus treated with linezolid or vancomycin: A secondary economic analysis of resource use from a Spanish perspective.
abstract: OBJECTIVE
  Adopting a unique Spanish perspective, this study aims to assess healthcare resource utilization (HCRU) and the costs of treating nosocomial pneumonia (NP) produced by methicillin-resistant Staphylococcus aureus (MRSA) in hospitalized adults using linezolid or vancomycin. An evaluation is also made of the renal failure rate and related economic outcomes between study groups.
  
  
  METHODS
  An economic post hoc evaluation of a randomized, double-blind, multicenter phase 4 study was carried out.
  
  
  METHODS
  Nosocomial pneumonia due to MRSA in hospitalized adults.
  
  
  METHODS
  The modified intent to treat (mITT) population comprised 224 linezolid- and 224 vancomycin-treated patients.
  
  
  METHODS
  Costs and HCRU were evaluated between patients administered either linezolid or vancomycin, and between patients who developed renal failure and those who did not.
  
  
  METHODS
  Analysis of HCRU outcomes and costs.
  
  
  RESULTS
  Total costs were similar between the linezolid- (€17,782±€9,615) and vancomycin-treated patients (€17,423±€9,460) (P=.69). The renal failure rate was significantly lower in the linezolid-treated patients (4% vs. 15%; P<.001). The total costs tended to be higher in patients who developed renal failure (€19,626±€10,840 vs. €17,388±€9,369; P=.14). Among the patients who developed renal failure, HCRU (days on mechanical ventilation: 13.2±10.7 vs. 7.6±3.6 days; P=.21; ICU stay: 14.4±10.5 vs. 9.9±6.6 days; P=.30; hospital stay: 19.5±9.5 vs. 16.1±11.0 days; P=.26) and cost (€17,219±€8,792 vs. €20,263±€11,350; P=.51) tended to be lower in the linezolid- vs. vancomycin-treated patients. There were no statistically significant differences in costs per patient-day between cohorts after correcting for mortality (€1000 vs. €1,010; P=.98).
  
  
  CONCLUSIONS
  From a Spanish perspective, there were no statistically significant differences in total costs between the linezolid and vancomycin pneumonia cohorts. The drug cost corresponding to linezolid was partially offset by fewer renal failure adverse events.
authors.affiliation: CIBERES, Universitat Autónoma de Barcelona, Spain. Electronic address: jrello@crips.es.
authors.forename: J
authors.initials: J
authors.lastname: Rello
authors.affiliation: Medicina Intensiva, Hospital Clínico Universitario de San Carlos, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Nieto
authors.affiliation: Medicina Intensiva, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de GC, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Solé-Violán
authors.affiliation: Pharmerit International, Bethesda, MA, United States.
authors.forename: Y
authors.initials: Y
authors.lastname: Wan
authors.affiliation: Pharmerit International, Bethesda, MA, United States.
authors.forename: X
authors.initials: X
authors.lastname: Gao
authors.affiliation: Pharmerit International, Bethesda, MA, United States.
authors.forename: C T
authors.initials: CT
authors.lastname: Solem
authors.affiliation: Pfizer, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: De Salas-Cansado
authors.affiliation: Pfizer, Madrid, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Mesa
authors.affiliation: Pfizer, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Charbonneau
authors.affiliation: Service de Réanimation Médicale, Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Chastre
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use*; D003428:Cross Infection; D004311:Double-Blind Method; D017048:Health Care Costs; D006801:Humans; D000069349:Linezolid / Q000191:economics / Q000627:therapeutic use; D008712:Methicillin; D055624:Methicillin-Resistant Staphylococcus aureus; D011023:Pneumonia, Staphylococcal / Q000188:drug therapy / Q000191:economics*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014640:Vancomycin / Q000191:economics / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D000069349:Linezolid; D008712:Methicillin
keywords: Economics; España; Farmacoeconomía; Insuficiencia renal; Methicillin-resistant Staphylococcus aureus; Neumonía; Pneumonia; Renal failure; Spain; Staphylococcus aureus resistente a meticilina