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Pharmacy World & Science

, 30:916 | Cite as

Vancomycin vs teicoplanin in the treatment of Gram-positive infections: a pharmacoeconomic analysis in a Turkish University Hospital

  • Aylin Acar SancarEmail author
  • Selen Yegenoglu
  • Robin de Vries
  • Maarten J. Postma
  • Nimet Simsek
  • Petros Pechlivanoglou
  • Serhat Unal
Research Article

Abstract

Objective The aim of this study was to estimate and compare the costs of vancomycin and teicoplanin in the treatment of Gram-positive hospital infections in Turkey using a cost minimisation analysis. Setting Hacettepe University Hospital, Ankara, Turkey. Method The health-care provider’s perspective was considered within formal pharmacoeconomic assessment methodology. The records of 76 patients who had been hospitalised and treated for Gram-positive infections at Hacettepe University Hospital between 16 July 2003 and 22 November 2003 were retrospectively evaluated to obtain individual data on resources and associated costs. Main outcome measure From a cost minimisation perspective, hospital directors may consider teicoplanin to be a relevant option in addition to vancomycin. Result The estimated mean treatment cost per patient was 1,780 TRY (1,101 EUR) for teicoplanin and 1,429 TRY (884 EUR) for vancomycin, with statistical analysis failing to reveal any significant difference between the two drugs in terms of these total costs (p = 0.33). This cost minimisation analysis shows that the average costs of vancomycin and teicoplanin per patient observed did not differ significantly. Conclusion Other potential advantages of one drug over the other, as reported by other authors, such as differing safety profiles or advantages in administration, may ultimately decide which is preferred.

Keywords

Cost minimisation analysis Glycopeptide Pharmacoeconomics Teicoplanin Turkey Vancomycin 

Notes

Funding

No funding was received for this study.

Conflicts of interest

The authors declare no conflict of interest in connection with this article.

References

  1. 1.
    Rodriguez-Bano J. Selection of empiric therapy in patients with catheter-related infections. Clin Microbiol Infect. 2002;8:275–81.PubMedCrossRefGoogle Scholar
  2. 2.
    Wood MJ. Chemotherapy for gram-positive nosocomial sepsis. J Chemother. 1999;11:446–52.PubMedGoogle Scholar
  3. 3.
    Pea F, Brollo L, Viale P, et al. Teicoplanin therapeutic drug monitoring in critically ill patients: a retrospective study emphasizing the importance of a loading dose. J Antimicrob Chemother. 2003;51:971–5.PubMedCrossRefGoogle Scholar
  4. 4.
    Wood MJ. The comparative efficacy and safety of teicoplanin and vancomycin. J Antimicrob Chemother. 1996;37:209–22.PubMedCrossRefGoogle Scholar
  5. 5.
    Murphy S, Pinney RJ. Teicoplanin or vancomycin in the treatment of gram-positive infections? J Clin Pharm Ther. 1995;20(1):5–11.PubMedCrossRefGoogle Scholar
  6. 6.
    Wilhelm MP, Estes L. Vancomycin. Mayo Clin Proc. 1999;74(9):928.PubMedGoogle Scholar
  7. 7.
    Ducharme MP, Slaughter RL, Edwards DJ. Vancomycin pharmacokinetics in a patient population: effect of age, gender and body weight. Ther Drug Monit. 1994;16:513–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Begg EJ, Barclay ML, Kirkpatrick CJM. The therapeutic monitoring of antimicrobial agents. J Clin Pharmacol. 1999;47:23–30.CrossRefGoogle Scholar
  9. 9.
    Hoeprich PD, Jordan MC, Ronald AR. Glycopeptides. In: Hoeprich PD, Jordan MC, Ronald AR, editors. Infectious diseases. Philadelphia: Lippincott; 1994. p. 256–8.Google Scholar
  10. 10.
    Kayaalp SO. Narrow spectrum antistaphylococcus and antianaerobic drugs and polypeptidic antibiotics. In: Kayaalp SO, editor. Medical pharmacology from the rational therapy perspective. Ankara: Feryal; 2002. p. 280–93.Google Scholar
  11. 11.
    Erjavec Z, de Vries-Hospers HG, Laseur M, et al. A prospective, randomized, double-blinded, placebo-controlled trial of empirical teicoplanin in febrile neutropenia with persistent fever after imipenem monotherapy. J Antimicrob Chemother. 2000;45:843–9.PubMedCrossRefGoogle Scholar
  12. 12.
    De Lalla F, Tramarin A. A risk-benefit assessment of teicoplanin in the treatment of infections. Drug Saf. 1995;13(5):317–28.PubMedCrossRefGoogle Scholar
  13. 13.
    Rubinstein E. Cost implications of home care on serious infections. Hosp Formul. 1993;26:46–50.Google Scholar
  14. 14.
    Ulusoy S, Unal S. Teicoplanin. Flora J. 2000;5(Suppl 1):3–15.Google Scholar
  15. 15.
    Darley ESR, MacGowan AP. The use and therapeutic drug monitoring of teicoplanin in the UK. Clin Microbiol Infect. 2004;10:62–9.PubMedCrossRefGoogle Scholar
  16. 16.
    Sahai J, Healy DP, Shelton MJ, et al. Comparison of a vancomycin and teicoplanin-induced histamine release and ‘red man syndrome’. Antimicrob Agents Chemother. 1990;34:765–9.PubMedGoogle Scholar
  17. 17.
    Spencer CM, Bryson HM. Teicoplanin. A pharmacoeconomic evaluation of its use in the treatment of gram-positive infections. Pharmacoeconomics. 1995;7(4):357–74.PubMedCrossRefGoogle Scholar
  18. 18.
    Rybak J. Teicoplanin vs vancomycin: cost-effectiveness comparisons. Hosp Formul. 1993;28(Suppl 1):28–32.PubMedGoogle Scholar
  19. 19.
    R Development Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing. Vienna, Austria; 2005.Google Scholar
  20. 20.
    Altman DG. Practical statistics for medical research. Florida: CRC; 1999.Google Scholar
  21. 21.
    Basu A, Manning WG, Mullahy J. Comparing alternative models: log vs Cox proportional hazard? Health Econ. 2004;13:749–65.PubMedCrossRefGoogle Scholar
  22. 22.
    Peng Y, Keith B, Dear G, Denham JW. A generalized F mixture model for cure rate estimation. Stat Med. 1998;17:813–30.PubMedCrossRefGoogle Scholar
  23. 23.
    Ahuja J, Gupta M, Gupta AK, et al. Pharmacoeconomics. Natl Med J India. 2004;17(2):80–3.PubMedGoogle Scholar
  24. 24.
    Vazquez L, Encinas MP, Morin LS, et al. Randomised prospective study comparing cost-effectiveness of teicoplanin and vancomycin as second line empiric therapy for infection in neutropenic patients. Haematologica. 1999;84:231–6.PubMedGoogle Scholar
  25. 25.
    Menichetti F. The role of teicoplanin in the treatment of febrile neutropenia. J Chemother. 2000;12(Suppl 5):34–9.PubMedGoogle Scholar
  26. 26.
    Carbone E, Nacinovich F, Stamboulian D. New therapeutic strategies with teicoplanin. Medicina (B Aires). 2002;62(Suppl 2):25–9.Google Scholar
  27. 27.
    Wickersham RM. Vancomycin. In: Wickersham RM, editor. Drug facts and comparisons. St. Louis: Facts and Comparisons; 2003. p. 1450–2.Google Scholar
  28. 28.
    Codina C, Miro JM, Tuset M, et al. Vancomycin and teicoplanin use as antibiotic prophylaxis in cardiac surgery: pharmacoeconomic study. Med Clin (Barc). 2000;114(Suppl 3):54–61.Google Scholar
  29. 29.
    Crane VS, Garabedian-Ruffalo SM. Current treatment of gram-positive infections: focus on efficacy, safety, and cost minimization analysis of teicoplanin. Hosp Formul. 1992;27(12):1199–200.PubMedGoogle Scholar
  30. 30.
    Simoens S, De Corte N, Laekeman G. Clinical practice and costs of treating catheter-related infections with teicoplanin or vancomycin. Pharm Pract. 2006;4(2):68–73.Google Scholar
  31. 31.
    Bucaneve G, Menichetti F, Favero AD. Cost analysis of 2 empiric antibacterial regimens containing glycopeptides for the treatment of febrile neutropenia in patients with acute leukaemia. Pharmacoeconomics. 1999;15(1):85–95.PubMedCrossRefGoogle Scholar
  32. 32.
    Abad F, Calbo F, Zapater P, et al. Comparative pharmacoeconomic study of vancomycin and teicoplanin in intensive care patients. Int J Antimicrob Agents. 2003;15:65–71.CrossRefGoogle Scholar
  33. 33.
    Davey PG, South R, Malek M. Impact of glycopeptide therapy after hospital discharge on inpatient costs: a comparison of teicoplanin and vancomycin. J Antimicrob Chemother. 1996;37:623–33.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  • Aylin Acar Sancar
    • 1
    Email author
  • Selen Yegenoglu
    • 2
  • Robin de Vries
    • 3
  • Maarten J. Postma
    • 3
  • Nimet Simsek
    • 4
  • Petros Pechlivanoglou
    • 3
  • Serhat Unal
    • 4
  1. 1.Pharmaceutical Care UnitMarmara University School of PharmacyHaydarpasa, IstanbulTurkey
  2. 2.Department of Pharmacy ManagementHacettepe University School of PharmacySihhiye, AnkaraTurkey
  3. 3.Groningen Research Institute of Pharmacy (GRIP)University of GroningenGroningenThe Netherlands
  4. 4.Department of Internal Medicine, Infectious Diseases UnitHacettepe University School of MedicineSihhiye, AnkaraTurkey

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