Costos del tratamiento de erradicación del Helicobacter pylori en pacientes con úlcera péptica / Costs of treatment of Helicobacter pylori erradication in patients with peptic ulcer

Introducción: El tratamiento actual de la úlcera péptica en su etapa aguda es la erradicación del Helicobacter pylori (HP) junto con tratamiento de la úlcera con inhibidores de la bomba de protones (IBP). Objetivos Determinar el costo del tratamiento de erradicación con 2 antibióticos por 7 ó 14 días y el costo de diferentes inhibidores de la bomba de protones por 42 días. material y Método: Se revisó un documento farmacológico que contenía los precios de todos los medicamentos con un valor promedio de dólares de 670 pesos. Se analizó presentaciones, dosis y costo del tratamiento. Resultados: Hubo una importante variación de precios de los 2 antibióticos evaluados: Claritromicina y Amoxicilina, con costos que variaban entre 11.000 y 26.000 por 7 días. En cuanto a IBP hay 19 Omeprazoles en el merfcado nacional, con costos de tratamiento por 42 días que varían entre 2.922 pesos y 33800 pesos. Hay 5 Lanzoprazoles y 3 Pantoprazoles. El costo final de todo el tratamiento completo puede variar entre 14.229 pesos y 116.936 pesos. Conclusiones: Los costos de este tratamiento son muy variables y afectan fuertemente el presupuesto de los pacientes. por lo tanto, los médicos que prescriben estos tratamientos deben estar informados claramente de los costos.

Comparative efficacy of amoxicillin, cefuroxime and clarithromycin in the treament of community - acquired pneumonia in children

To compare the clinical response to amoxicillin, cefuroxime and clarithromycin in the treatment of community-acquired pneumonia in children and to see the cost effectiveness of each treatment. Design: Randomized clinical control trial. Place and Duration of Study: Department of Pediatrics, Khyber Teaching Hospital, Peshawar, from October 2001 to February 2002. Subjects and Patients between 3 to 72 months of age, admitted in the hospital with community acquired pneumonia, were randomly divided into three groups,1,2,3. They were started on amoxicillin, cefuroxime and clarithromycin respectively. The patients were assessed daily. If there was no clinical improvement at 48 hours the antibiotic was changed. ANOVA statistical test was applied to see the clinical response to the treatment in the three groups. Cost effectiveness of the treatment was compared. There was no statistical difference in the clinical response at 48 hours of initiating treatment and at discharge [p > 0.01 each]. The mean hospital stay in group 1 and 2 was 3.3 days and group 3 was 3.2 days respectively [p > 0.01]. Ninety-seven% patients in group 1 and 3, and 95% patients in group 2 showed clinical improvement. The cost of treatment of community acquired pneumonia for 8 days was Rs 496/-, 730/-, 1018/- for amoxicillin, clarithromycin and cefuroxime respectively. Amoxicillin was found the most cost effective followed by clarithromycin and cefuroxime respectively in the treatment of non-severe and severe community-acquired pneumonia