A number of new
antibiotics have lately become available for treatment of lower
respiratory tract infections in out-patients. The new drugs are generally more expensive than the older ones, which might be justified by better effects, improved safety, or by other advantages. In this study, a retrospective economic analysis has been made using data from a previous trial comparing a new
macrolide,
roxithromycin, with an older 1,
erythromycin stearate in the treatment of lower
respiratory tract infections. The trial was multicentre, double blind, randomized and comparative. There were no significant differences in efficacy between treatments, although the cure rate was higher for
roxithromycin, 85% vs 79% for
erythromycin. 20/39 of the
erythromycin-treated patients reported adverse events, vs 7/40
roxithromycin-treated subjects, a highly significant difference. More detailed information was obtained by reviewing the medical records of the participants, and from questionnaires distributed to the 3 centres that had included patients in the trial. Additional visits were found necessary for 4 patients treated with
erythromycin and for 1 using
roxithromycin. Using the healing rates in the present investigation, and including costs for initial
drug treatments, second consultations, and failed
therapy, average cost-effectiveness (SEK/patient cured) was 409 for
roxithromycin-treated patients, and 488 for
erythromycin-treated.
Roxithromycin should then be cheaper than
erythromycin stearate. With the same healing rate,
roxithromycin would be less cost-effective, but indirect costs and effects on quality of life are not then taken into account.