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Cost Analysis of 2 Empiric Antibacterial Regimens Containing Glycopeptides for the Treatment of Febrile Neutropenia in Patients with Acute Leukaemia

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Author Info

  • Giampaolo Bucaneve

    (Istituto di Medicina Interna e Scienze Oncologiche, Policlinico Monteluce, Perugia, Italy)

  • Francesco Menichetti

    (Istituto di Malattie Infettive, Universita di Perugia, Perugia, Italy)

  • Albano Del Favero

    (Istituto di Medicina Interna e Scienze Oncologiche, Policlinico Monteluce, Perugia, Italy)

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    Abstract

    Objective: Patients with cancer-associated neutropenia are at high risk of developing severe infections which can be fatal if treatment is not promptly administered. For this reason, fever is treated as soon as possible with broad spectrum antibacterial therapy. The objective of this study was to conduct a cost analysis in Italy comparing 2 empiric glycoprotein-containing antibacterial regimens for the treatment of febrile neutropenia in patients with acute leukaemia. Design and setting: A retrospective cost analysis was conducted, using the records of 527 febrile neutropenic patients with acute leukaemia who participated in an 18-month multicentre (29 Italian haematological units) randomised trial during 1991. All patients received either of the following 2 empiric intravenous regimens, each containing 3 antibacterial agents: ceftazidime (2g, 3 times daily) and amikacin (15 mg/kg/day, in 3 separate doses) plus teicoplanin (6 mg/kg, in a single dose) or vancomycin (30 mg/kg/day, in 2 separate doses). Economic analyses were carried out from a hospital perspective. Only the direct costs per patient, i.e. mean antibacterial treatment and management cost, mean overall treatment failure cost and mean cost of adverse effects, were included. Main outcome measures and results: No differences were found in the clinical response, defined as the improvement in the rate of fever or infection (if documented), between the 2 regimens. However, tolerability, defined as the incidence of adverse effects probably or definitely related to the assigned treatment, was reported to be better with the teicoplanin- rather than the vancomycin-containing regimen. Conclusions: This retrospective cost analysis showed that despite the higher acquisition cost of teicoplanin relative to vancomycin, the lower incidence of adverse effects associated with teicoplanin and its ease of administration (single daily dose) resulted in equivalent overall treatment costs between teicoplanin- and vancomycin-containing regimens.

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    Bibliographic Info

    Article provided by Springer Healthcare | Adis in its journal PharmacoEconomics.

    Volume (Year): 15 (1999)
    Issue (Month): 1 ()
    Pages: 85-95
    Download reference. The following formats are available: HTML (with abstract), plain text (with abstract), BibTeX, RIS (EndNote, RefMan, ProCite), ReDIF
    Handle: RePEc:wkh:phecon:v:15:y:1999:i:1:p:85-95

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    Web page: http://pharmacoeconomics.adisonline.com/

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    Related research

    Keywords: Pharmacoeconomics; Cost-analysis; Ceftazidime; Amikacin; Teicoplanin; Vancomycin; Immunocompromised-infections; Neutropenia; Antibacterials; Leukaemia;

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