Abstract | STUDY OBJECTIVE: DESIGN: Pharmacoeconomic analysis performed at one of the sites participating in the prospective, randomized, double-blind, comparative, multicenter efficacy study. SETTING: Referral hospital with level 1 trauma center. PATIENTS: Eight-five adults with a suspected penetrating intraabdominal injury requiring laparotomy. INTERVENTIONS: Patients were randomized to receive aztreonam 2 g intravenously every 8 hours or gentamicin 2 mg/kg intravenous load followed by 5 mg/kg/day intravenously initially adjusted to peak concentrations of 6-8 micrograms/ml. All patients received clindamycin 900 mg intravenously every 8 hours. MEASUREMENTS AND MAIN RESULTS: Charge data were gathered from the hospital billing system and converted to cost data using an institutional cost:charge ratio of 0.6. Study drug and aminoglycoside monitoring costs were also calculated. Overall, 43 (97%) of 44 patients receiving A-C had a favorable clinical response compared with 35 (85.4%) of 41 receiving G-C (p = 0.052). The mean hospital cost of $66,336 for 7 infected patients was significantly higher than that of $8014 in 78 noninfected patients (p < 0.0001). Mean hospital costs of $12,058 and $13,742 for A-C and G-C groups, respectively, were not significantly different (p > 0.05) despite having only a single failure (total cost $162,666) in the A-C group. Similarly, mean pharmacy costs of $1411 and $1604, respectively, were not significantly different (p > 0.05). CONCLUSIONS: Hospital costs for infected patients with penetrating abdominal trauma exceed those of noninfected patients by 5-fold. Despite a lower infection rate in the A-C group, neither hospital nor pharmacy costs were significantly different compared with those in the G-C group.
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Authors | T C Fabian, B A Boucher, M C Croce |
Journal | Pharmacotherapy
(Pharmacotherapy)
1996 Sep-Oct
Vol. 16
Issue 5
Pg. 951-7
ISSN: 0277-0008 [Print] United States |
PMID | 8888092
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Gentamicins
- Clindamycin
- Aztreonam
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Topics |
- Abdominal Injuries
(drug therapy, economics)
- Adult
- Aztreonam
(economics, therapeutic use)
- Clindamycin
(economics, therapeutic use)
- Drug Costs
- Drug Therapy, Combination
(economics, therapeutic use)
- Female
- Gentamicins
(economics, therapeutic use)
- Health Care Costs
- Hospital Bed Capacity, 300 to 499
- Hospitals, Teaching
- Humans
- Male
- Retrospective Studies
- Tennessee
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