Abstract | BACKGROUND: METHODS: A retrospective chart review (2003-10) of AML patients receiving consolidation chemotherapy was performed. Patients were followed through their first cycle of consolidation chemotherapy. Antifungal prescribing patterns, clinical outcomes and resource consumptions were recorded. A decision analytical model was developed to depict the downstream consequences of using each antifungal agent, with success defined as completion of the designated course of initial antifungal prophylaxis without developing invasive fungal disease (IFD). Cost-effectiveness and sensitivity analyses were performed. RESULTS: A total of 106 consecutive patients were analysed. Baseline characteristics and predisposing factors for IFD were comparable between groups. Three IFDs (one proven, one probable and one suspected) occurred, all in the posaconazole group. Patients receiving posaconazole had the highest rate of intolerance requiring drug cessation (13% versus 7% in each of the fluconazole and voriconazole groups). Fluconazole conferred overall savings per patient of 26% over posaconazole and 13% over voriconazole. Monte Carlo simulation demonstrated a mean cost saving with fluconazole of AU$8430 per patient (95% CI AU$5803-AU$11 054) versus posaconazole and AU$3681 per patient (95% CI AU$990-AU$6319) versus voriconazole. One-way sensitivity analyses confirmed the robustness of the model. CONCLUSIONS:
|
Authors | Siow-Chin Heng, Monica A Slavin, Daoud Al-Badriyeh, Sue Kirsa, John F Seymour, Andrew Grigg, Karin Thursky, Ashish Bajel, Roger L Nation, David C M Kong |
Journal | The Journal of antimicrobial chemotherapy
(J Antimicrob Chemother)
Vol. 68
Issue 7
Pg. 1669-78
(Jul 2013)
ISSN: 1460-2091 [Electronic] England |
PMID | 23485723
(Publication Type: Comparative Study, Journal Article)
|
Chemical References |
- Antifungal Agents
- Pyrimidines
- Triazoles
- posaconazole
- Fluconazole
- Voriconazole
|
Topics |
- Adolescent
- Adult
- Aged
- Antifungal Agents
(administration & dosage, economics)
- Chemoprevention
(economics, methods)
- Consolidation Chemotherapy
- Economics, Pharmaceutical
- Female
- Fluconazole
(administration & dosage, economics)
- Humans
- Immunocompromised Host
- Leukemia, Myeloid, Acute
(complications, drug therapy)
- Male
- Middle Aged
- Mycoses
(prevention & control)
- Pyrimidines
(administration & dosage, economics)
- Retrospective Studies
- Treatment Outcome
- Triazoles
(administration & dosage, economics)
- Voriconazole
- Young Adult
|