PHARMACOECONOMIC ANALYSIS OF TREATMENT OF OUT-OF-HOSPITAL COMPLICATED ABDOMINAL INFECTIONS WITH NEW-GENERATION CARBAPENEM — ERTAPENEM

In a surgeon’s practice, complicated intra-abdominal infections (CII) are one of the most frequent nosological entities. E. Proteus spp., Klebsiella spp. are considered to be leading activators of out-of-hospital CII. For the first time in a Russian economic environment the authors, using mathematical modeling methods, have conducted a clinical and economic research of the new carbapenem, ertapenem, for monotherapy of complicated intra-abdominal infections. They have calculated the total cost, including the cost of CII treatment subject to indicators such as efficiency of treatment and infection-related probability of death (attributive lethality). Results of the «susceptible-infected-susceptible» model were used to assess the impact of acquired bacterial resistance on the efficacy of treating complicated intra-abdominal infections. As a result it was found that in the case of out-of-hospital complicated intraabdominal infections, it is more advisable from the clinical and economic standpoint to start treatment with ertapenem; less advisable is to start with the combination of ceftriaxone and metronidazole or the combination of ciprofloxacin and metronidazole. Key words: clinical and economic analysis, ertapenem, complicated intra-abdominal infections, resistance. (Pediatric Pharmacology. – 2010; 7(1):29-40

PHARMACOECONOMIC ANALYSIS OF TREATMENT OF OUT-OF-HOSPITAL COMPLICATED ABDOMINAL INFECTIONS WITH NEW-GENERATION CARBAPENEM — ERTAPENEM

In a surgeon’s practice, complicated intra-abdominal infections (CII) are one of the most frequent nosological entities. E. Proteus spp., Klebsiella spp. are considered to be leading activators of out-of-hospital CII. For the first time in a Russian economic environment the authors, using mathematical modeling methods, have conducted a clinical and economic research of the new carbapenem, ertapenem, for monotherapy of complicated intra-abdominal infections. They have calculated the total cost, including the cost of CII treatment subject to indicators such as efficiency of treatment and infection-related probability of death (attributive lethality). Results of the «susceptible-infected-susceptible» model were used to assess the impact of acquired bacterial resistance on the efficacy of treating complicated intra-abdominal infections. As a result it was found that in the case of out-of-hospital complicated intraabdominal infections, it is more advisable from the clinical and economic standpoint to start treatment with ertapenem; less advisable is to start with the combination of ceftriaxone and metronidazole or the combination of ciprofloxacin and metronidazole. Key words: clinical and economic analysis, ertapenem, complicated intra-abdominal infections, resistance. (Pediatric Pharmacology. – 2010; 7(1):29-40

ФАРМАКОЭКОНОМИЧЕСКИЙ АНАЛИЗ ЛЕЧЕНИЯ ВНЕБОЛЬНИЧНЫХ ОСЛОЖНЕННЫХ АБДОМИНАЛЬНЫХ ИНФЕКЦИЙ КАРБАПЕНЕМОМ НОВОГО ПОКОЛЕНИЯ — ЭРТАПЕНЕМОМ

In a surgeon’s practice, complicated intra-abdominal infections (CII) are one of the most frequent nosological entities. E. Proteus spp., Klebsiella spp. are considered to be leading activators of out-of-hospital CII. For the first time in a Russian economic environment the authors, using mathematical modeling methods, have conducted a clinical and economic research of the new carbapenem, ertapenem, for monotherapy of complicated intra-abdominal infections. They have calculated the total cost, including the cost of CII treatment subject to indicators such as efficiency of treatment and infection-related probability of death (attributive lethality). Results of the «susceptible-infected-susceptible» model were used to assess the impact of acquired bacterial resistance on the efficacy of treating complicated intra-abdominal infections. As a result it was found that in the case of out-of-hospital complicated intraabdominal infections, it is more advisable from the clinical and economic standpoint to start treatment with ertapenem; less advisable is to start with the combination of ceftriaxone and metronidazole or the combination of ciprofloxacin and metronidazole. Key words: clinical and economic analysis, ertapenem, complicated intra-abdominal infections, resistance. (Pediatric Pharmacology. – 2010; 7(1):29-40)В практике врача хирурга осложненные абдоминальные инфекции (ОАИ) — одни из наиболее часто встречающихся нозологических форм. Ведущими возбудителями внебольничных ОАИ считают E. coli, Proteus spp., Klebsiella spp. Авторами впервые в российских экономических условиях при помощи методов математического моделирования было произведено клинико-экономическое исследование использования нового карбапенема — эртапенема для монотерапии осложненных абдоминальных инфекций. Была рассчитана суммарная стоимость, включающая стоимость лечения ОАИ, с учетом таких показателей, как эффективность лечения и вероятность связанной с инфекциями смертей (атрибутивная летальность). Для оценки влияния приобретенной бактериальной резистентности на эффективность лечения осложненных абдоминальных инфекций были использованы результаты модели «восприимчивый — зараженный — восприимчивый». В результате было показано, что при внебольничных осложненных абдоминальных инфекциях с клинико-экономических позиций целесообразнее начинать лечение с эртапенема; менее целесообразно — с комбинации цефтриаксон + метронидазол или с комбинации ципрофлоксацина и метронидазола.Ключевые слова: клинико-экономический анализ, эртапенем, осложненные абдоминальные инфекции, резистентность. (Педиатрическая фармакология. – 2010; 7(1):29-40