ECONOMIC-ANALYSIS OF ANTIBIOTIC REGIMENS USED IN THE TREATMENT PHARYNGITIS - A PROSPECTIVE COMPARISON OF AZITHROMYCIN VERSUS ROXITHROMYCIN

The economic impacts in terms of cost and effectiveness (speed of reso lution of symptoms) of 3- and 5-day courses of azithromycin and a 10-d ay course of roxithromycin were compared in a randomized, open study i n patients with symptoms suggestive of beta-haemolytic streptococcal p haryngitis. Direct medical costs and absence from work were recorded a nd symptom scores and compliance were used to assess the effectiveness of therapies. Although no differences between treatment groups in ter ms of overall clinical response rates were detected 2 and 4 weeks afte r the start of treatment, more rapid resolution of symptoms was achiev ed with 3- and 5-day courses of azithromycin than with a 10-day course of roxithromycin. There was also a significant reduction in the time absent from work in the azithromycin treatment groups. The total costs of care over the 4-week evaluation period were lower for the 3- and 5 -day azithromycin courses (US$193.60 and US$195.30 respectively) than for roxithromycin (US%202.10). The major cost components were absence from work (58.6%), visits to the physician (15.3%) and utilization of antibiotics (14.9%). Compliance was significantly better (P < 0.01) in patients prescribed azithromycin for 3 and 5 days (58.0% and 42.9% re spectively) than in those who received roxithromycin (20.3%) and a sig nificantly longer symptom-free period (P < 0.01) was reported in azith romycin- compared with roxithromycin-treated patients. These findings support the hypothesis that a 3- or 5-day course of azithromycin is as effective as a 10 day course of roxithromycin in the treatment of pat ients with pharyngitis and is associated with lower costs. Furthermore , azithromycin is associated with faster resolution of symptoms and im proved patient compliance.