Comparison of beractant and calfactant in a neonatal intensive care unit

Purpose. The relative efficacy, complications, and cost of beractant and calfactant were studied. Methods. All patients admitted to a neonatal intensive care unit between January and November 2001 with an estimated gestational age (EGA) of less than or equal to29 weeks were included in this retrospective study. Neonates with an EGA of >29 weeks who required surfactant treatment because of respiratory distress syndrome (RDS) were also enrolled. The prophylaxis group included all neonates with an EGA of >29 weeks who received a prophylactic dose of surfactant within one hour of birth. The rescue group included neonates who did not receive a prophylactic dose, who demonstrated radiographic and clinical signs of RDS, and who received a rescue dose of surfactant. Results. Of 139 patients reviewed, 107 (77%) were included in the study. No significant difference between the two surfactants in either group was found in mean fraction of inspired oxygen (FiO(2)) at 72 hours, time to an FiO(2) of 30%, total number of doses per patient, and complications. The cost of surfactant administered per patient did not differ significantly between the two drugs in each group, but the cost of the amount wasted per patient did. The mean total cost of prophylaxis per patient was thus significantly higher for calfactant ($513) than for beractant ($379). Conclusion. Beractant and calfactant were similar in terms of efficacy, safety, and total number of doses per patient. However, calfactant was significantly more costly because of greater product waste.