COST-EFFECTIVENESS OF ABBREVIATING THE DURATION OF INTRAVENOUS ANTIBACTERIAL THERAPY WITH ORAL FLUOROQUINOLONES

Comprehensive economic analyses should include outpatient as well as i npatient resources. A healthcare system that includes both inpatient a nd outpatient care, such as prescriptions, physician care, laboratory tests and multiple other items, has been termed an Integrated Healthca re Network (IHN). Thus, costeffectiveness analyses from the perspectiv e of an IHN are necessary. We report a cost-effectiveness analysis fro m an MN perspective on 187 evaluable hospitalised patients with seriou s infections who participated in randomised clinical trials that evalu ated either: (i) standard regimens of intravenous (IV) antibacterial t herapy, usually followed by oral antibacterial therapy; or (ii) an abb reviated regimen of intravenous antibacterials for 2 to 4 days, follow ed by either oral ciprofloxacin or oral enoxacin as early switch thera py. Clinical success rates were similar for the 2 treatment groups. Th e median number of days of in-hospital antibacterial treatment was 11 for standard IV therapy and 10 for switch therapy. Adverse events occu rred in 33% of the standard IV therapy group and in 50% of the switch therapy group. Sensitivity analysis of drug price and hospital bed cos t showed that switch therapy was consistently more cost effective than standard IV therapy. Standard IV therapy would have to be 10% more ef fective than switch therapy to change the economic decision.In this an alysis, switch therapy was a cost-effective treatment with no demonstr ated change in efficacy compared with standard IV therapy.