A PHARMACOECONOMIC MODEL TO EVALUATE ANTIBIOTIC COSTS

Study Objectives. To characterize patient sociodemographics and health , describe vancomycin treatment parameters and clinician-rated outcome s, and determine costs associated with treatment including preparation and administration, adverse events, and toxicity Design. A prospectiv e study to develop a model for costs associated with antibiotic treatm ent (vancomycin). Setting. A community hospital. Patients. One hundred adults with active infections. Interventions. Mean duration of therap y was 10 days, and most patients received 2000 mg/day Serum concentrat ions were monitored in two of three patients. Detailed cost analyses w ere completed on a subset of 26 patients selected at random from the o verall sample. Measurements and Main Results. Sepsis and skin and skin structure infections were the most common indications for vancomycin therapy Treatment was effective in 81 patients, failed in 9, and was n ot evaluable in 10. Thirty-eight percent of patients experienced adver se events attributable to the drug. Phlebitis was common, and red man syndrome, nephrotoxicity, and ototoxicity were infrequent. Conclusions . Total cost of vancomycin treatment for 100 patients was $30,251: $23 ,855 for preparation and administration, $1710 for monitoring serum co ncentrations, and $4686 for treating adverse reactions. Drug costs acc ounted for only 55% of the total cost. Vancomycin is safe and effectiv e, but phlebitis is underreported and significantly affects cost.