Pharmacoeconomic Profile of Antibiotics Used in the Treatment of Lower Respiratory Tract Infections
in Geriatric Patients
WAWRUCH M., BOŽEKOVÁ L., KRČMÉRY S.1, KOZLÍKOVÁ K.2, FOLTÁN V.3, LAŠŠÁNOVÁ M., KRIŠKA M.
Lekárska fakulta Univerzity Komenského v Bratislave, Farmakologický ústav 1Lekárska fakulta Univerzity Komenského v Bratislave, Klinika geriatrie 2Lekárska fakulta Univerzity Komenského v Bratislave, Ústav lekárskej fyziky a biofyziky 3Farmaceutická fakulta Univerzity Komenského v Bratislave, Katedra organizácie a riadenia farmácie |
|
Summary:
The paper aims to evaluate the pharmacoeconomic profile of antibiotics (ATB) used in the treatment of lower
respiratory tract (LRT) infections and thus contribute to rationalization of therapeutic procedures. Of 2870 patients
hospitalized at the Geriatric Clinic of the Medical Faculty of Comenius University from 1 January 1999 to
31 December 2001, 189 patients with acute infections of the LRT were included in the retrospective study. For
pharmacoeconomic evaluation, cost effectiveness analysis was employed, the principal parameter of which, cost
effectiveness coefficient, was the ratio of the price of ATB treatment in Slovak crowns (SK) and the criterion of
effectiveness (E), the number of asymptomatic days in a month. The authors separately evaluated ATBs administered
perorally (p.o.); intravenously (i.v.), and sequentially, and they also compared i.v. and the corresponding
sequentially administered ATBs. Statistical comparison revealed significant differences in the prices and
cost effectiveness coefficients of individual alternatives of ATB treatment. Employed ATBs did not significantly
differ in the criteria of effectiveness. According to the cost effectiveness coefficient (SK/asymptomatic day),
fluoroquinolones were less expensive (median price/E: pefloxacin: p.o. 19.3; i.v. 29.1; sequentially administered
26.0, and ciprofloxacin: p.o., 14.7, i.v., 54.1, sequentially administered, 31.7). Sequential administration of
ATBs (ampicillin-sulbactam, cefuroxime, amoxicillin-klavulanate, ciprofloxacin) was significantly cheaper in
comparison with i.v. administration. With therapeutic equivalence, the total pharmacoeconomic profile of ATB
treatment depended on the price parameter. In the selection of ATB it is also necessary to consider the
price of the drug.
Key words:
pharmacoeconomics – cost effectiveness analysis – respiratory tract infections – antibiotics
– fluoroquinolones
|