Journal of General Internal Medicine

, Volume 1, Issue 6, pp 351–363

Cost-effective choice of antimicrobial therapy for serious infections

  • Milton C. Weinstein
  • J. Leighton Read
  • Donald N. MacKay
  • James J. Kresel
  • Howard Ashley
  • Katherine Taylor Halvorsen
  • H. Christina Hutchings
Original Articles

DOI: 10.1007/BF02596417

Cite this article as:
Weinstein, M.C., Read, J.L., MacKay, D.N. et al. J Gen Intern Med (1986) 1: 351. doi:10.1007/BF02596417

Abstract

The authors evaluated the financial and health implications of treatment choices for three serious classes of infection: hospital-acquired pneumonia, intra-abdominal infection, and sepsis of unknown origin. Data were obtained from a systematic review of clinical literature and published data bases, by written questionnaire from a panel of infectious disease authorities, and from actual costs at a tertiary-care hospital. For pneumonia and sepsis, the third-generation cephalosporin evaluated (ceftizoxime) was found to be less expensive than other regimens, when costs of dose preparation and administration, monitoring, and toxicity were added to drug acquisition costs. The lowestcost regimen for intra-abdominal infection was metronidazole plus gentamicin. Modest differences in efficacy would easily outweigh differences in toxicity, however, and could justify the use of more expensive regimens (e.g., mezlocillin plus gentamicin for hospital-acquired pneumonia, and cefoxitin plus gentamicin for intra-abdominal infection). If all regimens are assumed to be equally efficacious, then the third-generation cephalosporin was both lowest in cost and, owing to its low toxicity, greatest in net health benefit.

Key words

antibiotics cost-effectiveness decision analysis cephalosporin ceftizoxime 

Copyright information

© Society for Research and Education in Primary Care Internal Medicine 1986

Authors and Affiliations

  • Milton C. Weinstein
    • 5
  • J. Leighton Read
    • 5
    • 1
  • Donald N. MacKay
    • 2
  • James J. Kresel
    • 2
  • Howard Ashley
    • 5
  • Katherine Taylor Halvorsen
    • 3
  • H. Christina Hutchings
    • 4
  1. 1.the Nutrition and Metabolism LaboratoryNew England Deaconess HospitalBoston
  2. 2.the Departments of Medicine, Pharmacy Services, and Community and Family MedicineDartmouth-Hitchcock Medical CenterHanover
  3. 3.the College of Business AdministrationNortheastern UniversityBoston
  4. 4.the Division of Cost-Benefit StudiesSmith Kline Beckman CorporationPhiladelphia
  5. 5.Institute for Health ResearchHarvard School of Public HealthBoston

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