Abstract
Objective: This study aimed to evaluate the cost-effectiveness of ceftriaxone and non-ceftriaxone therapies in patients with typhoid fever.Methods: The applied method was a cost-effectiveness analysis. Data were retrospectively collected, and sampling was performed using totalsampling based on medical records and hospital information systems. Subjects were limited to patients diagnosed with typhoid fever and usingceftriaxone or non-ceftriaxone antibiotics. A total of 15 patients were investigated, comprising 10 patients on ceftriaxone and five patients using nonceftriaxoneantibiotics. Effectiveness was evaluated by the length of hospitalization. The cost was a median of total costs, consisting of the cost of thedrug, concomitant drugs, medical equipment, laboratory tests, doctor, health-care services, and hospitalization.Results: The results showed the effectiveness of ceftriaxone (3.80±0.789 days) did not differ with the non-ceftriaxone drugs (3.40±1.635 days).However, the total cost of ceftriaxone (Rp 1,929,355) was less than that of non-ceftriaxone antibiotics (Rp 2,787,003). The average cost-effectivenessratio of ceftriaxone group (Rp 507,725/effectiveness) was lower compared to the non-ceftriaxone (Rp 819,707/effectiveness).Conclusions: This study results showed that ceftriaxone was more cost-effective than non-ceftriaxone antibiotics.
Highlights
Typhoid fever is a bacterial infection caused by Salmonella enterica subspecies enterica serotype typhi or paratyphi A, B, or C [1]
In accordance with the Systematic Guideline for Typhoid Fever Control published in 2013, the first-line antimicrobial agents are chloramphenicol, ampicillin, amoxicillin, and trimethoprim-sulfamethoxazole
The research sample consisted of all hospitalized patients with typhoid fever using ceftriaxone or nonceftriaxone antibiotics in 2016 and met the inclusion criteria of the research
Summary
Typhoid fever is a bacterial infection caused by Salmonella enterica subspecies enterica serotype typhi or paratyphi A, B, or C [1]. Based on the WHO data, there are at least 21 million cases of typhoid fever and 222,000 deaths every year worldwide caused by the disease [2]. According to the data of Riskesdas (Indonesian Basic Health Research) in 2007, the prevalence of typhoid fever in Indonesia is 1.6% [3]. The rate of typhoid fever is estimated at 180.3/100,000 people per year [4]. In accordance with the Systematic Guideline for Typhoid Fever Control published in 2013, the first-line antimicrobial agents are chloramphenicol, ampicillin, amoxicillin (amoxicillin is safe to be used in pregnant patients), and trimethoprim-sulfamethoxazole. Other antibiotic options are used in the treatment of typhoid fever to this day [5]
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