Clinical and economic impact of appropriate empirical antibiotic therapy in complicated intra-abdominal infections: A retrospective study

Abstract

AimsTo study the comparative efficacy of Piperacillin/Tazobactam (PIP-TAZ) and new fixed dose combination (FDC) of ceftriaxone+sulbactam+ethylenediaminetetraacetic acid (EDTA) in treatment of intra-abdominal infections (IAIs) and to analyze the cost expenditures with these therapies. MethodsCase sheets of patients treated for IAI with either of PIP-TAZ or FDC were analyzed. Demographic characteristics, surgical procedure, antibiotic therapy and length of hospital stay were recorded and the cost of total hospital care was analyzed. Efficacy was measured in terms of microbiological and clinical successes. ResultsOut of 120 patients identified as culture positive, empirical PIP-TAZ was given in 58 patients, of whom 39 (67.24%) patients achieved clinical success. The remaining achieved success with either meropenem or meropenem+colistin combination. Out of 62 FDC treated patients, 54 (87.09%) achieved clinical success and the remaining patients were cured with FDC+colistin combination therapy. The clinical success rates in culture negative patients treated with FDC and PIP-TAZ were 87.5% and 21.42% respectively. Comparative cost expenditure analysis of the two treatment groups revealed that the overall treatment cost for successful patients treated with FDC was 36.72% lesser than that of PIP-TAZ treated groups. Similarly, the failed patient group also resulted in 35.44% higher expenditure in PIP-TAZ group than in FDC group. ConclusionThe study reveals the superior efficacy of FDC over PIP-TAZ treatment in IAIs which has a direct impact on the cost of treatment. The comparative pharmacoeconomic analysis shows that the selection of FDC over PIP-TAZ reduces up to 35% costs involved in IAIs treatments.