Cost-effectiveness analysis of low versus high dose colistin in the treatment of multi-drug resistant pneumonia: a comment
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To the editor
We read with great interest the article by Cara et al.  in a recently published issue of the International Journal of Clinical Pharmacy. This study was conducted to evaluate cost-effectiveness of high dose versus low dose colistin (HDC vs. LDC) in treatment of nosocomial pneumonia (NP) due to multidrug resistant gram-negative bacteria (MDR-GNB). The authors concluded that LDC is as effective as and less nephrotoxic than HDC and could be considered as a cost-effective treatment for MDR-GNB NP. The study topic is important; however we faced issues in the study methodology and interpretation of results that need to be highlighted.
A major concern arises from considering LDC as a previously proven approach in treatment of MDR-GNB NP. In this study, doses less than 2.5 mg/kg were considered as LDC and doses above 2.5 mg/kg were defined as HDC. Three studies were cited in the paper as the basis for proven efficacy of LDC. The first citation belongs the study by Kalin et al. [
Conflicts of interest
The authors have nothing to declare.