MULTIRESISTANT BACTERIA AND CURRENT THERAPY - THE ECONOMICAL SIDE OF THE STORY

作者：Wilke M H^*

来源：European Journal of Medical Research, 2010, 15(12): 571-576.

Severe infections with multiresistant bacteria (MRB) are a medical challenge and a financial burden for hospitals The adequate antibiotic therapy is a key issue in multiresistant bacteria management Several major cost drivers have been identified Remarkably drug acquisition costs are not necessarily included Most significant are the length of stay in hospital the hours of mechanical ventilation and the time treated on an intensive care unit
In a systematic review of the literature the following aspects were investigated
Do generic treatment strategies contribute in cost savings?
Are there specific results for recent antibiotics
Early adequate and effective antimicrobial treatment switch from i v to oral therapy adjusted dura non of therapy and adherence to guidelines have been found to be successful strategies
Looking at specific antibiotics the best evidence for cost effectiveness is found for Linezolid in treatment of cSSTI as well as in HAP Daptomycin shows good economic results in bloodstream infections so possibly being a cost effective alternative to vancomycin Looking at tigecycline the published data show neither higher costs nor savings compared to imipeneme Doripenem as one of the new est therapy options has pros en to be highly cost saving in HAP when corn pared with imipenem However most analyses are based on pharmacoeconomic modelling rather than on directly analysing trial data or real life clinical populations
Conclusion Using modern antibiotics in whole is not more expensive than using established therapies Mod ern antibiotics are cost effective and sometimes even cost saving This is especially true if an effective therapy is initiated as early as possible

• 出版日期2010-11-30