Background Levofloxacin exhibits excellent bioavailability as well as pharmacokinetic equivalence between the oral and the parenteral form and is one of the medicines most used in the treatment of CAP. PurposeThe purpose of this study is to evaluate the savings that may be achieved by treating patients affected with CAP with sequential treatment (switching from intravenous to oral treatment). Materials and MethodsBoth the cost and duration of treatment with levofloxacin were considered. The cost was given by: unitary cost of levofloxacin, cost of the nursing staff, cost of the material for parenteral infusion, cost of the hospitalisation. The duration was considered to be 5 days for patients without complications, 20 days for patients with complications and 10 days as the average in common clinical practise. This model was applied to reality in the S.C. Pneumologia of the ASO S. Croce and Carle of Cuneo. The patients hospitalised for CAP and treated with levofloxacin were individualised through the A.S.400 computerised applications. Results In 2011 351 patients were hospitalised and treated with levofloxacin tablets and/or vials in the Pneumology ward; 90% of them were suffering from CAP. For 10 days of treatment the sequential treatment would enable savings equal to 85€/patient. This saving would allow us to treat 12 more patients in a switched treatment regime. For 20 days of treatment the difference would be equal to 205€/patient quantifiable as 14 more patients with CAP treated in hospital without affecting the budget. Conclusions Oral treatment, as it is equally effective, turns out to be the best therapeutic alternative in terms of savings. In future we will analyse the discharge letters of these patients under the model used in this study, thus assessing the real savings. No conflict of interest.
Background Anidulafungin is a semisynthetic echinocandin, mainly used in invasive Candida infections in non-neutropenic patients, with a daily dose cost lower than other antifungal drugs used in candidiasis treatment. Purpose To prepare a mathematical model, able to produce an estimate of the savings that could be realised using anidulafungin instead of the other antifungals. Materials and Methods A pilot study was carried out at Turin hospital ‘Città della Salute e della Scienza’, involving two Intensive Care Units (ICUs), which are the major consumers of echinocandins. In these two ICUs: Data concerning consumption, prices and 2010 rebates for various antimycotics were collected; The medical records of 174 patients, admitted in 2010, were examined to identify all those instances where anidulafungin could have been appropriately used, instead of other antifungals. Based on the analysis of medical records, the substitution index of the other antimycotics with anidulafungin has enabled us to calculate its potential use and the saving that the hospital might be able to achieve. Results The analysis revealed a frequently inappropriate use of various antifungal drugs. The review of medical reports confirmed a 70% substitution index of liposomal amphotericin B with anidulafungin. In 2010, the hospital used 9,237 vials of caspofungin, anidulafungin and liposomal amphotericin B. If we assume 100% use of anidulafungin in instances where it would be appropriate in the two ICUs, the hospital could make savings exceeding Euro 100,000 per year. Results The ICUs in question account for 18% of the total vials. The possible savings that could be made by extending the analysis and application of the mathematical model to the entire hospital have not yet been investigated, but the model has confirmed the initial assumption of possibly saving money by using anidulafungin, according to approved indications, in substitution for other antimycotic drugs. No conflict of interest.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.