Clinical and Economic Expedience of Ertapenem Therapy of Complicated Urinary Tract Infection
Abstract
Clinical and economic investigation of various antibiotics use in the treatment of complicated urinary tract infection (CUTI) was performed under the Russian economic environment. The drugs of comparison were ertapenem, ceftriaxone and levofloxacin. Direct costs and their structure were shown, and the cost efficiency was calculated. Alternative analysis and one-side susceptibility analysis were performed. In complicated urinary tract infections when the major pathogens were Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis it was clinically and economically reasonable to start the treatment with ceftriaxone or ertapenem, while levofloxacin could be an alternative strategy. When the effects of the acquired resistance on the treatment effectiveness were evaluated (SIS model) it was shown that the pathogens susceptibility to ertapenem was preserved for a significantly longer time than that to ceftriaxone or levofloxacin (60 months). Such a parameter may serve as an additional evidence of the reasonable use of ertapenem as the starting treatment of CUTI.
About the Authors
A. S. Kolbin
St.Petersburg State University
Russian Federation
Russian Federation
S. V. Sidorenko
Research Institute of Children's Infections, St.Petersburg
Russian Federation
Russian Federation
K. A. Zagorodnikova
St.Petersburg State University
Russian Federation
Russian Federation
V. B. Musatov
St.Petersburg State University
Russian Federation
Russian Federation
A. A. Yakovlev
St.Petersburg State University
Russian Federation
Russian Federation
References
1. Перепанова Т.С. Комплексное лечение и профилактика госпитальной инфекции мочевых путей: Дис.. док. мед. наук. М.: 1996.
2. Синякова Л.A. Гнойный пиелонефрит (современная диагностика и лечение): Дисс.. докт. мед. наук. М.: 2002.
3. Falagas M.E., Gorbach S.L. Practice guidelines: urianry tract infections. Infect Dis Clin Pract 1995; 4: 4: 241-256.
4. Hermanides H.S., Hulscher M.E., Schouten J.A. et al. Development of quality indicators for the antibiotic treatment of complicated urinary tract infections: a first step to measure and improve care. Clin Infect Dis 2008; 46: 5: 703-711.
5. Caron F. Diagnosis and treatment of community-acquired urinary tract infections in adults: what has changed. Comments on the 2008 guidelines of the French Health Products Safety Agency (AFSSAPS). Presse Med 2010; 39: 1: 42-48.
6. Nicolle L. AMMI Canada Guidelines Committee. Complicated urinary tract infection in adults. Can J Infect Dis Med Microbiol 2005; 16: 6: 349-360.
7. Naber K.G., Bergman B., Bishop M.C. et al. EAU guidelines for the management of urinary tract infections and male genital tract infections. Eur Urol 2001; 40: 576-588.
8. The Sanford guide to antimicrobial therapy. Gilbert D.N., Moellering R.C., Epiopoulos G.M., Sande M.A. Eds. / USA, 2010.
9. Wells W.G., Woods G.L., Jiang Q. et al. Treatment of complicated urinary tract infection in adults: combined analysis of two randomized, double-blind, multicentre trials comparing ertapenem and ceftriaxone followed by appropriate oral therapy. JAC 2004; 53: S2: ii67-ii74.
10. Wagenlehner F.M.E., Naber K.G. Current challenges in the treatment of complicated urinary tract infections and prostatitis. Clin Microbiol Infect 2006; 12: S3: 67-80.
11. Grabe M., Bishop M.C., Bjerklund-Johansen T.E. et al. Guidelines on urological infections. Wagenlehner 2009.
12. Spellberg B., Guidos R., Gilbert D. et al. The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America. Clin Infect Dis 2008; 46: 2: 155-164.
13. Macgowan A.P. BSAC Working Parties on Resistance Surveillance. Clinical implications of antimicrobial resistance for therapy. J Antimicrob Chemother 2008; 62: Suppl 2: ii105-14.
14. Состояние антибиотикорезистентности в России (www.antibiotic.ru).
15. Burkhardt O., Derendorf H., Welte T. Ertapenem: the new carbapenem 5 years after first FDA licensing for clinical practice. Expert Opin. Pharmacother 2007; 8: 2: 237-256.
16. Система стандартизации в здравоохранении Российской Федерации. Отраслевой стандарт клинико-экономического исследования. Общие положения 91500.14.0001-2002. Министерство Здравоохранения Российской Федерации. Приказ от 27 мая 2002 года № 163.
17. Walley T., Haycox A., Boland A. (Eds.). Pharmacoeconomics. Elsevier Health Sciences, 2004.
18. Cost-effectiveness in Health and Medicine. Gold M.R., Siegel J.E., Russell L.B., Weinstein M.C. Eds. / New York: Oxford University Press. 1996
19. Бюллетень для оптовых покупателей и поставщиков медикаментов «Фармин-декс». (www.pharmindex.ru).
20. Peterson J., Kaul S., Khashab M. et al. A double-blind, randomized comparison of levofloxacin 750 mg once-daily for five days with ciprofloxacin 400/500 mg twice-daily for 10 days for the treatment of complicated urinary tract infections and acute pyelonephritis. Urology 2008; 71: 17-22.
21. Naber K.G., Bartnicki A., Bischoff W. et al. Gatifloxacin 200 mg or 400 mg once daily is as effective as ciprofloxacin 500 mg twice daily for the treatment of patients with acute pyelonephritis or complicated urinary tract infections. Int J Antimicrob Agents 2004 Mar; 23: Suppl 1: S41-53.
22. Sidorenko S.V., Ivanov D.V. Results of the study on antibiotic resistance emergence among pathogens of community-acquired urinary tract infections in Moscow. Phase I. Antibiot Khimioter 2005, 50: 3-10.
23. Weinstein M., O'Brien B., Hornberger J. et al. Principles of good practice of decision analytic modeling in health care evaluation: Report of the ISPOR Task Force on Good Research Practices-Modeling Studies.Value Health 2003; 6: 9-17.
24. Laxminarayan R., Brown G.M. Economics of antibiotic resistance: a theory of optimal use. J Environ Econ Manage 2001; 42: 183-206.
Review
For citations:
Kolbin A.S., Sidorenko S.V., Zagorodnikova K.A., Musatov V.B., Yakovlev A.A. Clinical and Economic Expedience of Ertapenem Therapy of Complicated Urinary Tract Infection. Antibiot Khimioter = Antibiotics and Chemotherapy. 2011;56(1-2):35-42. (In Russ.)
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