Colistin and polymyxin B for treatment of nosocomial infections in intensive care unit patients: pharmacoeconomic analysis
| Autor: | Natalia da Costa Duarte, Júlia Coelho França Quintanilha, Desanka Dragosavac, Karen Prado Herzer Mattos, Patricia Moriel, Gustavo Rafaini Lloret, Marília Berlofa Visacri, Antonio Luis Eiras Falcão |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.drug_class Polymyxin Pharmaceutical Science Pharmacy Toxicology 030226 pharmacology & pharmacy Drug Costs law.invention Cohort Studies 03 medical and health sciences Pharmacoeconomics 0302 clinical medicine law Internal medicine Intensive care medicine Humans Pharmacology (medical) Economics Pharmaceutical 030212 general & internal medicine Aged Polymyxin B Retrospective Studies Pharmacology Cross Infection Colistin business.industry Middle Aged Intensive care unit Anti-Bacterial Agents Transplantation Intensive Care Units Treatment Outcome Cost-minimization analysis Female lipids (amino acids peptides and proteins) business Brazil medicine.drug |
| Zdroj: | International Journal of Clinical Pharmacy. 41:74-80 |
| ISSN: | 2210-7711 2210-7703 |
| DOI: | 10.1007/s11096-018-0766-x |
| Popis: | Background The emergence and rapid spread of multidrug-resistant gram-negative bacteria related to nosocomial infections is a growing worldwide problem, and polymyxins have become important due to the lack of new antibiotics. Objectives To evaluate the outcomes and pharmacoeconomic impact of using colistin and polymyxin B to treat nosocomial infections. Setting Neurosurgical, cardiovascular, or transplantation intensive care unit (ICU) at the Clinical Hospital of the University of Campinas (São Paulo, Brazil). Method A retrospective cohort study was conduct in patients in the ICU. The renal function was determined daily during treatment by measuring the serum creatinine. A cost minimization analysis was performed to compare the relative costs of treatment with colistin and polymyxin B. Main outcomes measure The outcomes were 30-day mortality and frequency and onset of nephrotoxicity after beginning treatment. Results Fifty-one patients treated with colistin and 51 with polymyxin B were included. 30-day mortality was observed in 25.49% and 33.33% of patients treated with colistin and polymyxin B, respectively; Nephrotoxicity was observed in 43.14% and 54.90% of patients in colistin and polymyxin B groups, respectively; and onset time of nephrotoxicity was 9.86 ± 13.22 days for colistin and 10.68 ± 9.93 days for polymyxin B group. Colistin treatment had a lower cost per patient compared to the cost for polymyxin B treatment (USD $13,389.37 vs. USD $13,639.16, respectively). Conclusion We found no difference between 30-day mortality and nephrotoxicity between groups; however, colistin proved to be the best option from a pharmacoeconomic point of view. |
| Databáze: | OpenAIRE |
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