TITLE

Cost-effective approaches to the treatment of community-acquired pneumonia in the era of resistance

AUTHOR(S)
Kuti, J.L.; Capitano, B.; Nicolau, D.P.; Kuti, Joseph L; Capitano, Blair; Nicolau, David P
PUB. DATE
June 2002
SOURCE
PharmacoEconomics;2002, Vol. 20 Issue 8, p513
SOURCE TYPE
Academic Journal
DOC. TYPE
journal article
ABSTRACT
Community-acquired pneumonia (CAP) infects upwards of four million people in the US each year, of which 20% require subsequent hospitalisation. Consequently, it is a large contributor to excessive healthcare resource consumption and cost. Since the aetiology of CAP is not identified in a majority of patients, treatment is often empiric, aimed at the most common causes, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and the atypical pathogens (Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumophila). A variety of pharmaceutical agents exist for the treatment of CAP, most notably the cephalosporin and penicillin derivatives, the macrolide/azalide antibacterials, the newer tetracyclines, and most recently the respiratory fluoroquinolones. Choosing an agent is usually related to issues such as patient compliance, adverse event profiles, and the presence of resistance. Of these, resistance seems to be the main factor today. S. pneumoniae, the most common cause of CAP, is steadily acquiring resistance to a majority of the currently available antibacterials, thus further increasing costs due to prolonged hospitalisation, treatment of relapses and the use of more expensive antibacterials. Understanding and maximising the pharmacodynamic properties of the available antibacterials will not only prevent the emergence of resistance, thus prolonging their clinical utility, but also reduce the costs associated with treating the infection through rapid symptom improvement and earlier patient discharge. Numerous methods for reducing costs in patients with bacterial infections are documented in the literature and can be applied to CAP. Choosing monotherapy instead of combination therapy can reduce costs associated with the administration of the antibacterial. Agents with longer half-lives allow for once-daily administration, which in turn, leads to improved compliance, successful outcomes, and decreased costs. Administering antibacterials to maximise their pharmacodynamics, such as with continuous infusion of β-lactams, reduces the amount of drug needed in addition to savings associated with administration and supplies. Finally, transitioning patients to oral therapy as soon as they are clinically stable can significantly reduce the length of hospital stay, which is the major contributing factor of healthcare costs. The use of a clinical pathway in an institution is the most effective way to apply these cost-saving approaches in the treatment of CAP. These pathways should be specific to each institution, thus considering the resistance rates in the area and encouraging the use of the most active, cost-effective agents to produce rapid, positive clinical outcomes.
ACCESSION #
6969718

 

Related Articles

  • Comorbidities as a driver of the excess costs of community-acquired pneumonia in U.S. commercially-insured working age adults. Polsky, Daniel; Bonafede, Machaon; Suaya, Jose A. // BMC Health Services Research;2012, Vol. 12 Issue 1, p1 

    Background: Adults with certain comorbid conditions have a higher risk of pneumonia than the overall population. If treatment of pneumonia is more costly in certain predictable situations, this would affect the value proposition of populations for pneumonia prevention. We estimate the economic...

  • Moxifloxacin cost saving for community-acquired pneumonia.  // PharmacoEconomics & Outcomes News;5/31/2008, Issue 554, p4 

    The article discusses a research study which revealed that moxifloxacin is less costly than a combination of levofloxacin and ceftriaxone for the treatment of community-acquired pneumonia (CAP) in Germany.

  • News in brief...  // PharmacoEconomics & Outcomes News;8/14/2004, Issue 459, p10 

    Discusses research being done on the treatment costs for community-acquired pneumonia (CAP) in an employed U.S. population. Reference to a study by G. L. Colice, et al published in the June 2004 issue of "Chest"; Estimated mean treatment cost for an inpatient episode of CAP and for an...

  • BETTER PROCESSES = BETTER OUTCOMES.  // Trustee;Feb2007, Vol. 60 Issue 2, p7 

    The article reports that improving the process of treating pneumonia and heart bypass patients could save hospitals $1.4 billion annually, according to a demonstration project by Orlando, Florida-based Premier Inc. The analysis found that all health care savings could have been realized in 2004...

  • Linezolid tops vancomycin for MRSA NP in Germany.  // PharmacoEconomics & Outcomes News;5/16/2009, Issue 578, p6 

    The article discusses research on the cost effectiveness of the use of linezolid than vancomycin to treat suspected meticillin-resistant Staphylococcus aureus nosocomial pneumonia (MRSA NP). It references a study by S. Sorensen et al published in the April 2009 issue of "Infection." The cost and...

  • Costs and health care resource utilization among chronic obstructive pulmonary disease patients with newly acquired pneumonia. Junji Lin; Yunfeng Li; Haijun Tian; Goodman, Michael J.; Gabriel, Susan; Nazareth, Tara; Turner, Stuart J.; Arcona, Stephen; Kahler, Kristijan H. // ClinicoEconomics & Outcomes Research;2014, Vol. 6, p349 

    Background: Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for lung infections and other pathologies (eg, pneumonia); however, few studies have evaluated the impact of pneumonia on health care resource utilization and costs in this population. The purpose of...

  • ANALYSIS OF ANTIBIOTIC USE IN VAP (VENTILATOR-ASSOCIATION PNEUMONIA) PATIENTS. Maharani Wahyuning Tyas; Suprapti, Budi; Hardiono; Agung Dwi Wahyu Widodo // Folia Medica Indonesiana;2013, Vol. 49 Issue 3, p168 

    VAP is a nosocomial infection that most often occurs in the ICU. VAP increases morbidity, mortality, treatment costs and hospitalization time in the ICU. Antibiotic is primary therapy in VAP. The initial selection of antibiotic is very important to determind outcome in VAP patients, as well as a...

  • Household health care-seeking costs: experiences from a randomized, controlled trial of communitybased malaria and pneumonia treatment among under-fives in eastern Uganda. Matovu, Fred; Nanyiti, Aisha; Rutebemberwa, Elizeus // Malaria Journal;2014, Vol. 13 Issue 1, p1 

    Background Home and community-based combined treatment of malaria and pneumonia has been promoted in Uganda since mid 2011. The combined treatment is justified given the considerable overlap between the symptoms of malaria and pneumonia among infants. There is limited evidence about the extent...

  • Can enteral antibiotics be used to treat pneumonia in the surgical intensive care unit? A clinical outcomes and cost comparison. Elofson, Kathryn A.; Forbes, Rachel C.; Gerlach, Anthony T. // International Journal of Critical Illness & Injury Science;Jul-Sep2015, Vol. 5 Issue 3, p149 

    Background: Controlling healthcare costs without compromising patient care is a focus given recent healthcare changes in the United States. The purpose of this study was to assess clinical improvement in surgical intensive care unit (SICU) patients initiated on or transitioned to enteral...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics