Cost Analysis of Imipenem-Cilastatin Versus Clindamycin with Tobramycin in the Treatment of Acute Intra-Abdominal Infection

Gregory de Lissovoy, Anne Elixhauser, Bryan R. Luce, Joan Weschler, Paul Mowery, Joseph Reblando, Joseph Solomkin

Research output: Contribution to journalArticle

Abstract

Clinical effectiveness of imipenem/cilastatin (I/C) versus tobramycin with clindamycin (T + C) in treatment of patients presenting with suspected acute intra-abdominal infection was assessed in a multicentre randomised clinical trial conducted during 1985 to 1986. The principal finding was a lower incidence of treatment failure among patients in the I/C arm (p = 0.043). We now report results of retrospective analysis of hospital treatment costs during an episode of infection incurred by patients enrolled in the trial. Treatment costs (in 1989 US dollars) were calculated from a hospital perspective, using an intention-to-treat analysis. Among 161 patients with low illness severity (APACHE II ⩽ 14) the mean cost for the episode of care was $US7038 in the I/C arm versus $US8404 for the T + C regimen; the difference was not statistically significant (p = 0.40). For 93 more severely ill patients (APACHE II score > 14) the mean cost for the I/C arm was $US 19 985 versus $US 16 582 for the T + C regimen; the difference was not statistically significant (p = 0.36). Multiple regression analysis, controlling for patient demographics and study site, showed that the cost of the episode was positively associated with the severity of illness (p <0.01) and presence of malnutrition (p <0.01), but that the total cost of the episode of infection was not statistically different for the 2 drug regimens (p = 0.45).

Original languageEnglish (US)
Pages (from-to)203-214
Number of pages12
JournalPharmacoEconomics
Volume4
Issue number3
DOIs
StatePublished - 1993

Fingerprint

Intraabdominal Infections
Tobramycin
Clindamycin
Costs and Cost Analysis
APACHE
Health Care Costs
Therapeutics
Episode of Care
Intention to Treat Analysis
Hospital Costs
Infection
Treatment Failure
Malnutrition
imipenem drug combination cilastatin
Randomized Controlled Trials
Regression Analysis
Demography
Incidence
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Pharmacology
  • Medicine (miscellaneous)

Cite this

de Lissovoy, G., Elixhauser, A., Luce, B. R., Weschler, J., Mowery, P., Reblando, J., & Solomkin, J. (1993). Cost Analysis of Imipenem-Cilastatin Versus Clindamycin with Tobramycin in the Treatment of Acute Intra-Abdominal Infection. PharmacoEconomics, 4(3), 203-214. https://doi.org/10.2165/00019053-199304030-00005

Cost Analysis of Imipenem-Cilastatin Versus Clindamycin with Tobramycin in the Treatment of Acute Intra-Abdominal Infection. / de Lissovoy, Gregory; Elixhauser, Anne; Luce, Bryan R.; Weschler, Joan; Mowery, Paul; Reblando, Joseph; Solomkin, Joseph.

In: PharmacoEconomics, Vol. 4, No. 3, 1993, p. 203-214.

Research output: Contribution to journalArticle

de Lissovoy, G, Elixhauser, A, Luce, BR, Weschler, J, Mowery, P, Reblando, J & Solomkin, J 1993, 'Cost Analysis of Imipenem-Cilastatin Versus Clindamycin with Tobramycin in the Treatment of Acute Intra-Abdominal Infection', PharmacoEconomics, vol. 4, no. 3, pp. 203-214. https://doi.org/10.2165/00019053-199304030-00005
de Lissovoy, Gregory ; Elixhauser, Anne ; Luce, Bryan R. ; Weschler, Joan ; Mowery, Paul ; Reblando, Joseph ; Solomkin, Joseph. / Cost Analysis of Imipenem-Cilastatin Versus Clindamycin with Tobramycin in the Treatment of Acute Intra-Abdominal Infection. In: PharmacoEconomics. 1993 ; Vol. 4, No. 3. pp. 203-214.
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