TITLE

Nitrofurantoin Compares Favorably to Recommended Agents as Empirical Treatment of Uncomplicated Urinary Tract infections in a Decision and Cost Analysis

AUTHOR(S)
MCKLNNELL, JAMES A.; STOLLENWERK, NICHOLAS S.; JUNG, CHIN W.; MILLER, LOREN G.
PUB. DATE
June 2011
SOURCE
Mayo Clinic Proceedings;Jun2011, Vol. 86 Issue 6, p480
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVE: To analyze the costs of nltrofurantoin use compared to those of other antibiotics recommended for treatment of uncomplicated urinary tract infection (UTI). PATIENTS AND METHODS: We used a decision analysis model to perform cost-minimization and sensitivity analyses to determine the level of trlmethoprim-sulfamethoxazole (TMP-SMX) and fluoroqulnolone resistance that would favor the use of nltrofurantoln as a first-line empirical treatment of uncomplicated UTIs. The model used a program perspective to evaluate costs. RESULTS: Nitrofurantoin was cost-minimizing when the prevalence of fluoroqulnolone resistance exceeded 12% among uropathogens or the prevalence of TMP-SMX resistance exceeded 17%. On 2-way sensitivity analysis, variables that had a significant Impact on our cost-minimization threshold included cost of antibiotics and probability of clinical cure with antibiotics. CONCLUSION: From a payer perspective, nltrofurantoln appears to be a reasonable alternative to TMP-SMX and fluoroquinolones for empirical treatment of uncomplicated UTIs, especially given the current prevalence of antibiotic resistance among community uropathogens. On the basis of efficacy, cost, and low Impact on promoting antimicrobial resistance, clinicians should consider nItrofurantoin as a reasonable alternative to TMP-SMX and fluoroqulnolones for first-line therapy for uncomplicated UTIs.
ACCESSION #
62094792

 

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