Differential costs and outcomes among pediatric oral antibiotic formulations identified from a large prescription database

Differential performance of oral antibiotics continues to be a difficult ch aracteristic to measure, As payers make efforts to identify selected antibi otics to place on their formularies or to reimburse, the challenge to these decisionmakers is to determine which agent will work best in their populat ion. Given the differences from one clinical trial to another, identifying performance characteristics that might impact effectiveness in clinical pra ctice is quite challenging. This study's aim was to determine which beta-lactam and macrolide antibioti c provided the best clinical and economic outcome when used in difficult pe diatric infections that previously experienced amoxicillin or cotrimoxazole failure. The findings demonstrated that cefaclor, azithromycin, and amoxicillin/clav ulanate were associated with a decreased need for subsequent antibiotic the rapy, Total drug treatment casts for beta-lactams and macrolides were lowes t for cefaclor and azithromycin, respectively. These results are consistent with previous published literature and seem plausible given potential comp liance advantages of these products as reported in studies of product toler ability and taste.