Pharmacoeconomics of intravenous antibiotic use in serious infection.

A pharmacoeconomic study of 15 antibiotics available in Barbados was performed. The antibiotics studied were amoxycillin/clavulanate, ampicillin, ampicillin/sulbactam, cefazolin, cefotaxime, ceftazidime, ceftriaxone, clindamycin, cloxacillin, cotrimoxazole, gentamicin, imipenem, metronidazole, piperacillin, piperacillin/tazobactam, and vancomycin. The costs of use of these compounds were calculated for a five-day course using a formula comprising eight categories: antibiotic purchase cost, maintenance of intravenous access, drug delivery cost, drug monitoring cost, dose readjustment, general monitoring cost, 'sharps' disposal cost and adverse effects. The costs of adverse effects were not included in this study due to lack of accurate data. The total cost of antibiotic use (in U.S. dollars) ranged from $42.52 to $463.73 per five-day course. Generic compounds were less expensive ($45.52 - $98.23) than brand-name compounds ($106.18 - $106.18 - $463.73). Antibiotic purchase costs accounted for proportions of total costs ranging from 7 to 93%. Non-drug costs represented a much greater proportion of total costs of generic compounds. For most compounds the non-drug costs were related to the frequency of dosing, but for gentamicin the non-drug costs were relatively higher because of the need for monitoring of serum gentamicin levels. Efficacy and freedom from side-effects will remain the most important determinants in the choice of antibiotic therapy. However, pharmacoeconomic analyses can provide prescribers with the information required to make cost-effective choices for treatment of their patients.

Pharmacoeconomics of intravenous antibiotic use in serious infections

A pharmacoeconomic study of 15 antibiotics available in Barbados was performed. The antibiotics studied were amoxycillin/clavulanate, ampicillin/sulbactam, cefazolin, cefotaxime, ceftazidime, ceftriaxone, clindamycin, cloxacillin, cotrimoxazole, gentamicin, imipenem, metronidazole, piperacillin/tazobactam, and vancomycin. The costs of use of these compound were calculated for a five-day course using a formula comprising eight categories: antibiotic purchase cost, maintenance of intravenous access, drug delivery cost, drug monitoring cost, dose readjustment, general monitoring cost, 'sharps' disposal cost and adverse effects. The cost of adverse effects were not included in this study due to lack of accurate data. The total cost of antibiotic use (in U.S. dollars) ranged from $42.52 to $463.73 per five-day course. Generic compound were less expensive ($45.52-$98.23) than brand-name compounds ($106.18 - $463.73). Antibiotic purchase costs accounted for proportions of total costs ranging from 7 to 93 percent. Non-drug costs represented a much greater proportion of total costs of generic compounds. For most compound the non-drug costs were related to the frequency of dosing, but for gentamicin the non-drug costs were relatively higher because of the need for monitoring of serum gentamicin levels. Efficacy and freedom from side-effects will remain the most important determinants in the choice of antibiotic therapy. However, pharmacoeconomic analyses can provide prescribers with the information required to make cost-effective choices for treatment of their patients

Pharmacoeconomics of intravenous antibiotic use in serious infections

A pharmacoeconomic study of 15 antibiotics available in Barbados was performed. The antibiotics studied were amoxycillin/clavulanate, ampicillin/sulbactam, cefazolin, cefotaxime, ceftazidime, ceftriaxone, clindamycin, cloxacillin, cotrimoxazole, gentamicin, imipenem, metronidazole, piperacillin/tazobactam, and vancomycin. The costs of use of these compound were calculated for a five-day course using a formula comprising eight categories: antibiotic purchase cost, maintenance of intravenous access, drug delivery cost, drug monitoring cost, dose readjustment, general monitoring cost, 'sharps' disposal cost and adverse effects. The cost of adverse effects were not included in this study due to lack of accurate data. The total cost of antibiotic use (in U.S. dollars) ranged from $42.52 to $463.73 per five-day course. Generic compound were less expensive ($45.52-$98.23) than brand-name compounds ($106.18 - $463.73). Antibiotic purchase costs accounted for proportions of total costs ranging from 7 to 93 percent. Non-drug costs represented a much greater proportion of total costs of generic compounds. For most compound the non-drug costs were related to the frequency of dosing, but for gentamicin the non-drug costs were relatively higher because of the need for monitoring of serum gentamicin levels. Efficacy and freedom from side-effects will remain the most important determinants in the choice of antibiotic therapy. However, pharmacoeconomic analyses can provide prescribers with the information required to make cost-effective choices for treatment of their patients (AU)

Pharmacoeconomics of intravenous antibiotic use in serious infection - abstract

A pharmacoeconomic study of 15 antibiotics available in Barbados was performed. The antibiotics studied were amoxycillin/clavulanate, ampicillin, ampicillin/sulbactam, cefazolin, cefotaxime, ceftazidime, ceftriaxone, clindamycin, cloxacillin, co-trimoxazole, gentamicin, irnipenem, metronidazole, piperacillin, piperacillin/tazobactam, and vancomycin. The costs of use of these compounds using a formula comprising eight categories: antibiotic purchase cost, maintenance of IV access, drug delivery cost, drug monitoring cost, dose readjustment, general monitoring cost, sharps disposal cost and adverse effects. The costs of adverse effects were not included in this study due to lack of accurate data. The total costs of antibiotic use (in Barbados dollars) ranged from $85.04 to $927.46 per five-day course. Generic compounds were less expensive ($85.04 - $236.02) than brand-name compounds ($212.25 - $927.46). Antibiotic purchase costs accounted for proportions of total costs ranging from 7 per cent to 93 per cent. Non-drug costs represented a much greater proportion of total costs of generic compounds. For most compounds the non-drug costs were related to the frequency of dosing, but for gentamicin the non-drug costs were relatively higher because of the need for monitoring serum gentamicin levels. Efficacy and freedom from side-effects will remain the most important determinants in the choice of antibiotic therapy. However, pharmacoeconomic analyses can provide clinicians with the information required to make cost-effective choices for treatment of their patients (AU)

Breast radiography: phantom, equipment performance, and radiation dosage comparisons for twenty-eight major mammography centers in the midwest. Work in progress.

This preliminary report discusses mammography tests that were conducted at 28 midwest medical centers. Equipment-parameter measurements were made, and images that were obtained with the Stanton Mark IIR Mammography Phantom were studied to compare image quality. These tests indicate that variations in equipment parameters and techniques can result in differences in the imaging of various sized phantom fibril and speck groups.

Large antral odontoma as the cause of acute maxillary sinusitis: report of case.

A case of a large compound odontoma in the right maxillary sinus causing acute maxillary sinusitis is reported. Seven large antral odontomas have been previously reported, none with the typical findings of acute sinusitis. Radiographs should always be considered in cases of recurrent maxillary sinusitis or pain, and the general practitioner should familiarize himself with lesions of the maxillary sinus that might be revealed in radiographic examination. Surgical excision is the preferred treatment for all odontomas, with no expectancy of recurrence. The odontoma described here was associated with an unusual bonelike capsule or cyst covering its superior surface, which necessitated careful exploration and dissection.

Temporomandibular joint ankylosis: review of the literature and report of two cases of bilateral involvement.

The factors predisposing to ankylosis and the probable pathogenesis are discussed, as treatment, both past and present. Arthroplasty with Silastic interposition is presented as an acceptable means of managing ankylosis, as shown in two case reports. The ultimate postoperative result is dependent on surgical timing, surgical technique, and attention to postsurgical physiotherapy.

Developing mental health programs in areas lacking professional facilities: The community consultant approach in New Mexico.

New Mexico has devised a district consultant approach to initiate mental health services in outlying, professionally "underdeveloped" areas. Each multicounty district is served by one locally based, fulltime professional consultant-a psychologist, social workers, or mental health nurse-augmented by a part time traveling psychiatrist. The program has emphasized community development, mainly through consultation, inservice training, and interagency coordination.