English, Article edition: Cost Effectiveness of Ciprofloxacin plus Metronidazole versus Imipenem-Cilastatin in the Treatment of Intra-Abdominal Infections Daniel J. Walters; Joseph S. Solomkin; Joseph A. Paladino

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Bookmark: http://trove.nla.gov.au/version/93689
Physical Description
  • article
Language
  • English

Edition details

Title
  • Cost Effectiveness of Ciprofloxacin plus Metronidazole versus Imipenem-Cilastatin in the Treatment of Intra-Abdominal Infections
Author
  • Daniel J. Walters
  • Joseph S. Solomkin
  • Joseph A. Paladino
Physical Description
  • article
Notes
  • Objective: To compare the cost effectiveness of sequential intravenous (IV) to oral ciprofloxacin plus metronidazole (CIP/​MTZ IV/​PO) with that of IV ciprofloxacin plus IV metronidazole (CIP/​MTZ IV) and IV imipenem-cilastatin (IMI IV) in patients with intra-abdominal infections. Design and participants: Patients enrolled in a double-blind randomised clinical trial were eligible for inclusion into this cost-effectiveness analysis. Decision analysis was used to characterise the economic outcomes between groups and provide a structure upon which to base the sensitivity analyses. 1996 cost values were used throughout. Setting: The economic perspective of the analysis was that of a hospital provider. Main outcome measures and results: Among 446 economically evaluable patients, 176 could be switched from IV to oral administration. The 51 patients randomised to CIP/​MTZ IV/​PO who received active oral therapy had a success rate of 98%, mean duration of therapy of 9.1 days and mean cost of $US7678. There were 125 patients randomised to either CIP/​MTZ IV or IMI IV who received oral placebo while continuing on active IV antibacterials; their success rate was 94%, mean duration of therapy was 10.1 days and mean cost was $US8774 (p =​ 0.029 vs CIP/​MTZ IV/​PO). Of the 270 patients who were unable to receive oral administration, 97 received IMI IV and had a success rate of 75%, mean duration of therapy of 13.8 days and a mean cost of $US12 418, and 173 received CIP/​MTZ IV and had a success rate of 77%, mean duration of therapy of 13.4 days and mean cost of $US12 219 (p =​ 0.26 vs IMI IV). Conclusions: In patients able to receive oral therapy, sequential IV to oral treatment with ciprofloxacin plus metronidazole was cost effective compared with full IV courses of ciprofloxacin plus metronidazole or imipenem-cilastatin. In patients unable to receive oral therapy, no difference in mean cost was found between IV imipenem-cilastatin or IV ciprofloxacin plus IV metronidazole.
  • Pharmacoeconomics, Ciprofloxacin, Metronidazole, Imipenem.cilastatin, Intra-abdominal-infections, Sequential-therapy, Intravenous, Oral, Randomised-controlled-trials, Cost-effectiveness, Resource-use, Antibacterials
  • RePEc:wkh:phecon:v:16:y:1999:i:5:p:551-561
Language
  • English
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