Cost-effectiveness in the hospital use of antibiotics: introductory considerations.

A cost-effectiveness analysis was performed for three antibiotic drug therapies in pneumonia and bronchopneumonia: broad spectrum penicillins, III generation cephalosporins and ceftriaxone. The study was based on records from 117 patients in 9 general medical departments in North and Central Italy during 1989. Costs included direct cost of drugs, staff, accommodation, and other hospital costs. Effectiveness was measured radiographically as clinical cure, interruption of therapy or death. The effectiveness and shorter duration of therapy with ceftriaxone in respect to the other treatments, produced a 15.18% savings of hospital resources compared with other III generation cephalosporins, and a 14.76% savings compared with broad spectrum penicillins. This is a provisional conclusion requiring confirmation with a larger number of patients and randomized trials.

Cost-effectiveness comparison of single and multiple-dose antibiotic treatment of lower uncomplicated urinary tract infections.

This study analyzed the cost-effectiveness of antibiotic treatments of different durations for acute cystitis in non-pregnant females. Questionnaires were sent to 400 practitioners evenly distributed throughout Italy. Data are reported from 2,069 patients. The clinical bacteriological efficacy at 10-15 days was 86.4% for single-dose treatment with fosfomycin-trometamol (FT), and 81.8% for the multiple-dose antibiotics group (MDAG). Disappearance of symptoms occurred in 2.1 days with FT and 3.4 days with MDAG. With FT 93.8% of patients were free of adverse events and 86.9% with MDAG. Analysis of the cost-effectiveness indicators for cure rate and absence of adverse events showed that treatment costs were similar for all antibiotics. FT needed less time interval for symptoms to disappear with a slightly higher cost than for MDAG, which had a better cost/effectiveness ratio.