Pharmacoeconomics of Piperacillin/Tazobactam and Imipenem/Cilastatin in the treatment of patients with intra-abdominal infections

Cost-Minimization Analysis of Piperacillin/Tazobactam versus Imipenem/Cilastatin for the Treatment of Serious Infections: A Canadian Hospital Perspective

“…Although our conclusions generally agree with those of Jhee et al, 8 our study also included the costs of resources that were not characterized by the previous investigators. As a result of the rigorous study design we used (i.e., ran-160 s The Annals of Pharmacotherapy s 1999 February, Volume 33 domized, blinded, with an intention-to-treat analytical design), our pharmacoeconomic analysis was also less susceptible to potential investigator bias.…”

“…12 There has been only one previously published P/T pharmacoeconomic analysis based on the results of a clinical trial. 8 In this US study, I/C was given in a 2-g/d regimen while P/T was administered as a 12-g/d regimen for the treatment of perforated or gangrenous appendicitis. Jhee et al compared the resource utilization related to the clinical management of the study infection in each of the treatment arms from the perspective of a US hospital.…”

“…Some limitations of our study include the use of a heterogeneous sample of patients. Although a more homogenous sample, such as that described by Jhee et al, 8 permits an assessment of the usefulness of a drug for specific infections, it does not permit an assessment of the relative cost-effectiveness of the study drugs when used for a multitude of infections as would be expected in a tertiary acute-care hospital setting. In conducting this analysis, we included only direct medical costs and did not include indi-rect costs such as loss of productivity or pain and suffering because: (1) we wanted to focus on providing easily accessible information to decisionmakers interested in cost containment; (2) issues on quality of life and suffering were not addressed by the clinical trial; and (3) these indirect costs are less relevant in the management of acute infections in hospitalized patients.…”

“…[4][5][6][7] Prior to 1996, there were four published clinical trials comparing P/T with I/C. [8][9][10][11] These studies were randomized, prospective trials involving intraabdominal infections or nosocomial pneumonia. Only one of these studies was blinded.…”