Cost effectiveness analysis of ceftriaxone and levofloxacin for therapy of urinary tract infection at Soebandi public hospital

Abstract

Background: An ideal therapeutic option should be effective and have a low cost. The first-line therapy of urinary tract infection (UTI) includes cephalosporin and fluoroquinolone. Objective: To find out which antibiotic therapy is more cost-effective between ceftriaxone and levofloxacin using a cost-effectiveness analysis test. Method: The study was conducted retrospectively using medical records and patient direct medical cost data for 2019 and 2020. The records of 21 patients met the inclusion criteria. Data processing and decision-making were carried out using descriptive and inferential statistical analysis, average cost-effectiveness (ACER) calculations, and a cost-effectiveness grid. The outcome parameter used in a cost-effectiveness analysis was the percentage of effectiveness of empirical therapy. Result: The results showed that 61.9% of patients received ceftriaxone and 38.1% received levofloxacin. The average length of hospitalisation of UTI patients with levofloxacin therapy was shorter than those treated with ceftriaxone (four versus five days) with a p-value = 0.066. The average cost of ceftriaxone treatment was higher than that of levofloxacin (IDR 2,352,307 versus IDR 1,867,183). Based on statistical analysis carried out on each component of direct medical cost, the results were not significantly different between the cost of treatment with ceftriaxone or levofloxacin (p = 0.107). The percentage of effectiveness of empirical therapy using levofloxacin was higher than ceftriaxone (100% versus 90.5%). ACER value of total levofloxacin cost (IDR 18,672 per percentage effectiveness) has a lower value compared to ceftriaxone (IDR 26,000 per percentage effectiveness). Conclusion: Using the cost-effectiveness grid, levofloxacin is a more effective therapy, therefore the treatment of UTIs at Soebandi public hospital using levofloxacin are more cost-effective.