VII World Conference on Clinical Pharmacology and Therapeutics

15-20 Jule, 2000, Florence, Italy
Poster P-A3 # 76

Cost Assessement of 3 Antibacterial Regimens for Treatment of Febrile Neutropenia

A.V. BEDENKOV

Department of Clinical Pharmacology and Antimicrobial Chemotherapy, State Medica Academy, Smolensk, Russia

The PDF format poster (34 kb)

• Introduction
• Objective
• Regimens
• Materials and methods
• Results
• Conclusions

INTRODUCTION

During cancer treatment, the appearence of fever with neutropenia is the first manifistation of potentialy life-threatining bacterial infection. The current standart of patient management involves the empirical intravenous administration of combination of antibacterials or a single broad spectrum agent.

The recent articles [Freifeld A et al. N Engl J Med, 1999; 341: 305-11 and Kern WV et al. N Engl J Med, 1999; 341: 312-18] have shown that oral administration of antibacterials could be an acceptble alternative to intravenous treatment for patients with febrile neutropenia and low-risk of complications (neutrophil count less than 500/mm³ but more than 100/mm³, duration of neutropenia 7-10 days). It should be noted, that more patients in the oral regimen groups that in the intravenous regimens groups reported diarrhea or other gastrointestinal symptoms.

OBJECTIVE

To compare the cost of oral and intravenous regimens of therapy for low-risk febrile patients with neutropenia.

REGIMENS

1. Amoxicillin-Clavulanate (625 mg, per os, t.i.d) plus Ciprofloxacine (750 mg, per os, b.i.d.); 2. Ceftriaxone (2 g, iv, o.d.) plus Amikacin (20 mg per kg, iv infusion, o.d.); 3. Ceftazidime (2 g, iv, t.i.d.). Duration of all regimens - 10 days.

MATERIALS AND METHODS

Data sourses: 1. Russian Farmaceutical bulletin, # 90, 1999; 2. Price list of Smolensk Regional Hospital for 1999.

The cost was calculated by summing up the acquisition cost of drugs and the cost of both the materials used and the time spent by the staff to administer the therapy.

We took into assessment all the generics that were available in Russia in September 1999. They are: Augmentin (SmithKline Beecham), Amoksiklav (Lek), Ciprobay (Bayer), Ciprinol (KRKA), Rocephin (Roche), Longaceph (ICN Galenika), Lendacin (Lek), Amikacin (ICN Galenica), Amikacin (Sintez, Russia), Amikin (Bristol-Myers Squibb), Fortum (Glaxo Wellcome).

RESULTS

The cost of Ceftriaxone/Amicacin intravenous regimen makes up from 175.5 USD [Lendacin/Amikacin (Sintez)] to 690.3 USD [Rocephin/Amikacin (ICN Galenika)]. The cost of Ceftazidime intravenous regimen is 579 USD [Fortum]. The cost of Amoxicillin-Clavulanate/Ciprofloxacine oral regimen ranges from 37.6 USD [Amoksiklav/Ciprinol] to 108.3 USD [Augmentin/Ciprobay]. (fig. 1)

Fig. 1. Cost of antibacterial regimens for treatment of febrile neutropenia

CONCLUSIONS

The cheapest antibacterial therapeutic regimen for low-risk febrile patients with neutropenia in Russia is Amoxicillin-Clavulanate/Ciprofloxacine with the following generics: Amoksiklav/Ciprinol.