COST-EFFECTIVENESS OF CEFTRIAXONE IN THE TREATMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULT HOSPITAL PATIENTS - A PHARMACO-ECONOMIC STUDY BASED ON A METAANALYSIS

Objectives. A retrospective analysis was conducted to assess the cost- effectiveness of four intravenous antibiotic treatment regimens in the treatment of severe community-acquired pneumonia (CAP) in adults in a private hospital setting, The study compared some third-generation ce phalosporin regimens with a second-generation cephalosporin and an amo xiciilin/clavulanic acid (co-amoxiclav) regimen to investigate publish ed South African treatment guidelines from a pharmacoeconomic point of view. Method. A pharmaco-economic model of local costs, from a payer perspective, was based on the results of a meta-analysis of clinical p apers from peer-reviewed journals, The study compared intravenous (IV) ceftriaxone (2 g once daily), cefotaxime (IV 2 g 3 times a day), cefu roxime (IV 750 mg 3 times a day, followed by 500 mg orally 3 times a d ay) and amoxicillin/clavulanic acid (IV 750 mg 3 times a day, followed by 625 mg orally 3 times a day). Results, An analysis of the odds rat ios (ORs) of all two-way comparisons indicated that ceftriaxone ensure d significantly higher probabilities of successful outcomes than the o ther antibiotic treatment regimens (ORs in the order of two were indic ated), The pharmaco-economic results suggested that the ceftriaxone tr eatment regimen was the most cost-effective in the hospital treatment of CAP in adult patients. These results proved to be robust across sen sitivity analyses for success rates and treatment days. A sensitivity analysis testing the assumption that patients could be discharged once the oral treatment was initiated indicated that the amoxicillin/clavu lanic acid and cefuroxime treatment arms were more cost-effective. The clinical validity of such an assumption is questionable. Conclusion. Despite the conservative approach followed in terms of ceftriaxone dat a, both the clinical results and cost-effectiveness supported the use of ceftriaxone setting.