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Cost-effectiveness analysis of parenteral antimicrobials for acute melioidosis in Thailand

Hantrakuna, Viriya, Chierakul, Wirongrong, Chetchotisakd, Ploenchan, Anunnatsiri, Siriluck, Currie, Bart J., Peacock, Sharon J., Day, Nicholas P. J., Cheah, Phaik, Limmathurotsakul, Direk and Lubell, Yoel (2015). Cost-effectiveness analysis of parenteral antimicrobials for acute melioidosis in Thailand. Transactions of the Royal Society of Tropical Medicine and Hygiene,109(6):416-418.

Document type: Journal Article
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IRMA ID 11381xPUB71
Title Cost-effectiveness analysis of parenteral antimicrobials for acute melioidosis in Thailand
Author Hantrakuna, Viriya
Chierakul, Wirongrong
Chetchotisakd, Ploenchan
Anunnatsiri, Siriluck
Currie, Bart J.
Peacock, Sharon J.
Day, Nicholas P. J.
Cheah, Phaik
Limmathurotsakul, Direk
Lubell, Yoel
Journal Name Transactions of the Royal Society of Tropical Medicine and Hygiene
Publication Date 2015
Volume Number 109
Issue Number 6
ISSN 0035-9203   (check CDU catalogue  open catalogue search in new window)
Start Page 416
End Page 418
Total Pages 3
Place of Publication United Kingdom
Publisher Oxford University Press
Field of Research MEDICAL AND HEALTH SCIENCES
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
Melioidosis is a common community-acquired infectious disease in northeast Thailand associated with overall mortality of approximately 40% in hospitalized patients, and over 70% in severe cases. Ceftazidime is recommended for parenteral treatment in patients with suspected melioidosis. Meropenem is increasingly used but evidence to support this is lacking.

Methods
A decision tree was used to estimate the cost-effectiveness of treating non-severe and severe suspected acute melioidosis cases with either ceftazidime or meropenem.

Results
Empirical treatment with meropenem is likely to be cost-effective providing meropenem reduces mortality in severe cases by at least 9% and the proportion with subsequent culture-confirmed melioidosis is over 20%.

Conclusions
In this context, treatment of severe cases with meropenem is likely to be cost-effective, while the evidence to support the use of meropenem in non-severe suspected melioidosis is not yet available.
DOI http://dx.doi.org/10.1093/trstmh/trv002   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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