Cost-effectiveness analysis of parenteral antimicrobials for acute melioidosis in Thailand.

Abstract

BACKGROUND:

Melioidosis is a common community-acquired infectious disease in northeast Thailand associated with overall mortality of approximately 40% in hospitalized patients, and over 70% in severe cases. Ceftazidime is recommended for parenteral treatment in patients with suspected melioidosis. Meropenem is increasingly used but evidence to support this is lacking.

METHODS:

A decision tree was used to estimate the cost-effectiveness of treating non-severe and severe suspected acute melioidosis cases with either ceftazidime or meropenem.

RESULTS:

Empirical treatment with meropenem is likely to be cost-effective providing meropenem reduces mortality in severe cases by at least 9% and the proportion with subsequent culture-confirmed melioidosis is over 20%.

CONCLUSIONS:

In this context, treatment of severe cases with meropenem is likely to be cost-effective, while the evidence to support the use of meropenem in non-severe suspected melioidosis is not yet available.

• Authors: Viriya Hantrakun, Wirongrong Chierakul, Ploenchan Chetchotisakd, Siriluck Anunnatsiri, Bart J Currie, Sharon J Peacock, Nicholas P J Day, Phaik Yeong Cheah, Phaik Cheah, Direk Limmathurotsakul, Yoel Lubell
• Journal: Transactions of the Royal Society of Tropical Medicine and Hygiene (Trans R Soc Trop Med Hyg) Vol. 109 Issue 6 Pg. 416-8 (Jun 2015) ISSN: 1878-3503 [Electronic] England
• PMID: 25972345 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: [email protected].

Chemical References

• Anti-Infective Agents
• Thienamycins
• Ceftazidime
• Meropenem

Topics

• Anti-Infective Agents (economics, therapeutic use)
• Ceftazidime (economics, therapeutic use)
• Cost-Benefit Analysis
• Female
• Humans
• Male
• Melioidosis (drug therapy, economics, epidemiology)
• Meropenem
• Thailand (epidemiology)
• Thienamycins (economics, therapeutic use)
• Treatment Outcome