ECONOMIC-ANALYSIS OF TREATMENT WITH ROXITHROMYCIN IN COMPARISON WITH ERYTHROMYCIN IN PATIENTS WITH LOWER RESPIRATORY-TRACT INFECTIONS

A number of new antibiotics have lately become available for treatment of lower respiratory tract infections in out-patients. The new drugs are generally more expensive than the older ones, which might be justi fied by better effects, improved safety, or by other advantages. In th is study, a retrospective economic analysis has been made using data f rom a previous trial comparing a new macrolide, roxithromycin, with an older 1, erythromycin stearate in the treatment of lower respiratory tract infections. The trial was multicentre, double blind, randomized and comparative. There were no significant differences in efficacy bet ween treatments, although the cure rate was higher for roxithromycin, 85% vs 79% for erythromycin. 20/39 of the erythromycin-treated patient s reported adverse events, vs 7/40 roxithromycin-treated subjects, a h ighly significant difference. More detailed information was obtained b y reviewing the medical records of the participants, and from question naires distributed to the 3 centres that had included patients in the trial. Additional visits were found necessary for ? patients treated w ith erythromycin and for 1 using roxithromycin. Using the healing rate s in the present investigation, and including costs for initial drug t reatments, second consultations, and failed therapy, average cost-effe ctiveness (SEK/patient cured) was 409 for roxithromycin-treated patien ts, and 488 for erythromycin-treated. Roxithromycin should then be che aper than erythromycin stearate. With the same healing rate, roxithrom ycin would be less cost-effective, but indirect costs and effects on q uality of Life are not then taken into account.