Antibacterial Treatment of Meticillin-Resistant Staphylococcus Aureus Complicated Skin and Soft Tissue Infections: a Cost and Budget Impact Analysis in Greek Hospitals

被引：7
作者：
Athanasakis K. [1 ]
Petrakis I. [2 ]
Ollandezos M. [1 ]
Tsoulas C. [2 ]
Patel D.A. [3 ]
Karampli E. [1 ]
Kyriopoulos J. [1 ]
机构：
[1] Department of Health Economics, National School of Public Health, 196 Alexandras Ave., Athens
[2] Pfizer Hellas, Athens
[3] Pharmerit International, Bethesda, MD
来源：
Infectious Diseases and Therapy | 2014年 / 3卷 / 2期
关键词：
Antibacterial agents; Complicated skin and soft tissue infection; Cost analysis; Daptomycin; Greek hospitals; Linezolid; Meticillin-resistant Staphylococcus aureus; Teicoplanin; Tigecycline; Vancomycin;
D O I：
10.1007/s40121-014-0044-8
中图分类号：
学科分类号：
摘要：
Methods: Equal efficacy was assumed for the pharmacotherapies under evaluation and resource use was elicited via an expert panel of seven local infectious disease specialists. The model was based on a previously published economic model that was adapted for the Greek hospital setting and included a decision tree for the management of hospitalized patients with MRSA-cSSTIs, which simulated costs and outcomes for the duration of hospitalization according to the therapeutic scenario. Inpatient costs consisted of hospitalization, diagnostic/laboratory testing, physician visits and antibiotic treatment.; Results: Current economic impact of MRSA-cSSTIs for the inpatient setting in Greek hospitals was estimated at €29,196,218. Total per patient cost according to first-line agent was €2,457, €2,762, €2,850, €3,494 and €3,094 and mean length of stay was 9.2, 12.5, 10.3, 13.0 and 14.0 days for linezolid, vancomycin, daptomycin, tigecycline, and teicoplanin, respectively. An estimated 10,287 MRSA-cSSTI patients are treated annually in Greek hospitals. Thus, increasing the use of linezolid by 11% over a 3-year period (current use 19%; 3 year projection 30%), for the management of MRSA-cSSTIs, could result in 3-year savings of €896,065.; Conclusion: Management of MRSA-cSSTI requires intensive resource use; overall healthcare costs differ according to the chosen first-line treatment. In light of considerable budget constraints, development of hospital strategies which facilitate early discharge, such as the introduction of clinical criteria and guidelines for switching from intravenous to oral MRSA-cSSTI therapy, could result in substantial savings for the Greek hospital budget.; Introduction: Meticillin-resistant staphylococcus aureus (MRSA) is an important cause of antimicrobial-resistant infections worldwide. Its prevalence remains high in the Greek hospital setting. Complicated skin and soft tissue infections (cSSTIs) due to MRSA are associated with prolonged hospitalization, additional healthcare costs and significant morbidity. The purpose of this study was to conduct a cost analysis and a budget impact analysis relative to different management scenarios for MRSA-cSSTIs from a hospital perspective. © 2014, The Author(s).
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页码：257 / 268
页数：11
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共 32 条
  • [1] Garau J., Ostermann H., Medina J., Et al., Current management of patients hospitalized with complicated skin and soft tissue infections across Europe (2010–2011): assessment of clinical practice patterns and real-life effectiveness of antibiotics from the REACH study, Clin Microbiol Infect, 19, 9, pp. E377-E385, (2013)
  • [2] Zervos M.J., Freeman K., Vo L., Et al., Epidemiology and outcomes of complicated skin and soft tissue infections in hospitalized patients, J Clin Microbiol, 50, 2, pp. 238-245, (2012)
  • [3] Dryden M.S., Complicated skin and soft tissue infection, J Antimicrob Chemother, 65, s3, pp. iii35-iii44, (2010)
  • [4] Dryden M., Complicated skin and soft tissue infections caused by methicillin-resistant Staphylococcus aureus: epidemiology, risk factors, and presentation, Surg Infect (Larchmt), 9, s1, pp. s3-s10, (2008)
  • [5] Moet G.J., Jones R.N., Biedenbach D.J., Stilwell M.G., Fritsche T.R., Contemporary causes of skin and soft tissue infections in North America, Latin America, and Europe: Report from the SENTRY Antimicrobial Surveillance Program (1998–2004), Diagn Microbiol Infect Dis, 57, 1, pp. 7-13, (2007)
  • [6] Stryjewski M.E., Chambers H.F., Skin and soft-tissue infections caused by community-acquired methicillin-resistant Staphylococcus aureus, Clin Infect Dis, 46, s5, pp. S368-S377, (2008)
  • [7] Sharpe J.N., Shively E.H., Polk H.C., Clinical and economic outcomes of oral linezolid versus intravenous vancomycin in the treatment of MRSA-complicated, lower-extremity skin and soft-tissue infections caused by methicillin-resistant Staphylococcus aureus, Am J Surg, 189, 4, pp. 425-428, (2005)
  • [8] White B., Seaton R.A., Complicated skin and soft tissue infections: literature review of evidence for and experience with daptomycin, Infect Drug Resist, 4, pp. 115-127, (2011)
  • [9] Sevinc F., Prins J.M., Koopmans R.P., Et al., Early switch from intravenous to oral antibiotics: guidelines and implementation in a large teaching hospital, J Antimicrob Chemother, 43, 4, pp. 601-606, (1999)
  • [10] Laing R.B., Mackenzie A.R., Shaw H., Gould I.M., Douglas J.G., The effect of intravenous-to-oral switch guidelines on the use of parenteral antimicrobials in medical wards, J Antimicrob Chemother, 42, 1, pp. 107-111, (1998)
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