| Pharmacoeconomic analysis of empirical therapy with ceftazidime alone or combination antibiotics for febrile neutropenia in cancer patients. | |
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MedLine Citation:
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PMID: 10155293 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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There is evidence to suggest that single-agent broad spectrum antibacterials may be cost-effective alternatives to combination antibiotics for the empirical management of febrile neutropenia in cancer patients. The objectives of the present study were 2-fold. The first objective was to compare the clinical effectiveness of ceftazidime monotherapy with that of 2 combination antibiotic regimens in cancer patients with febrile neutropenia. The 2 comparator regimens consisted of tobramycin plus piperacillin, either with (regimen 'CAP') or without (regimen 'AP') cefazolin. The second objective was to perform a cost-effectiveness analysis of the 3 regimens. Meta-analysis of randomised comparative trials between the 3 therapy groups was performed to determine the average overall response rate after 3 to 5 days of treatment. Seven clinical studies were selected for analysis. The overall incidence of adverse drug reactions (ADRs) was determined using the results of comparative and noncomparative studies. A comparative cost-analytic model was applied from a hospital perspective. The costs of primary therapy, hospitalisation, laboratory tests, routine patient care and treating ADRs were calculated, as were future costs. Monotherapy with ceftazidime was associated with an overall response rate of 63.5% and mean per-patient costs of $Can12,000 to $Can14,000. In comparison, regimen AP was associated with an overall response rate of 58.8% and mean costs of $Can13,000 to $Can16,000 per patient. The overall response rate in patients receiving CAP was 75.3%, and the mean cost per patient was $Can11,000 to $Can12,000. Thus, regimen CAP was the most cost-effective therapy from a hospital perspective. |
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Authors:
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G Dranitsaris; T M Tran; A McGeer; L Narine |
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Publication Detail:
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Type: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: PharmacoEconomics Volume: 7 ISSN: 1170-7690 ISO Abbreviation: Pharmacoeconomics Publication Date: 1995 Jan |
Date Detail:
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Created Date: 1995-11-14 Completed Date: 1995-11-14 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9212404 Medline TA: Pharmacoeconomics Country: NEW ZEALAND |
Other Details:
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Languages: eng Pagination: 49-62 Citation Subset: T |
Affiliation:
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Department of Pharmacy, Ontario Cancer Institute/Princess Margaret Hospital, Toronto, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Anti-Bacterial Agents / economics*, therapeutic use* Ceftazidime / economics*, therapeutic use* Clinical Trials as Topic Cost-Benefit Analysis Drug Costs Drug Therapy, Combination Fever / drug therapy*, economics Health Care Costs Humans Middle Aged Neoplasms / complications*, economics Neutropenia / drug therapy*, economics Randomized Controlled Trials as Topic Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 78439-06-2/Ceftazidime |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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