M. Genc et Pa. Mardh, COST-EFFECTIVE TREATMENT OF UNCOMPLICATED GONORRHEA INCLUDING COINFECTION WITH CHLAMYDIA-TRACHOMATIS, PharmacoEconomics, 12(3), 1997, pp. 374-383
We evaluated the cost effectiveness of treating uncomplicated gonorrho
ea in a theoretical cohort of 1000 adults (nonpregnant women of reprod
uctive age, or men) with either intramuscular ceftriaxone 125mg or a s
ingle oral dose of cefixime 400mg, ofloxacin 400mg or ciprofloxacin 50
0mg. We assumed that all patients were also empirically treated for un
complicated chlamydial infection, with either a single oral dose of az
ithromycin 1g, or oral doxycycline 100mg twice daily for 7 days. Treat
ment of gonorrhoea with intramuscular ceftriaxone was found to be the
most cost-effective alternative. This was followed by treatment with t
he either of the fluoroquinolones (ofloxacin or ciprofloxacin), then c
efixime. For empirical treatment of uncomplicated chlamydial infection
, doxycycline was more cost effective than azithromycin when approxima
tely more than 80% of the patients were assumed to comply with the dox
ycycline regimen. When patients' compliance was poor with the doxycycl
ine regimen, the azithromycin therapy became more cost effective from
a societal viewpoint. Nevertheless, its relatively high cost to the in
dividual patient with limited financial resources might prevent him or
her from filling prescriptions. Any decrease in patients' compliance
with the azithromycin therapy would favour treatment with doxycycline.