Pharmacoeconomics of appropriate antimicrobial use

1. Resources eve

2. There are u

0732 SSDlO732-88

recognizing

the costs associa

consultation

ba~ac~conomics

take

is essen

n-

es

of treatment is a cost, and required means that a re-

ore a~en~on s

ing (Figure 1). Ideally, antimicrobial policies should be based on local information that considers the

In practice, infection often presents as an emergency, and therefore, the diagnosis and initial man-

wit e

7.6 (5.8-9.4)

7.3 (5.L9.5)

it of Aminoglycos~ 3 Resul%sof an Patients in Dunded

Interpretable assays (paired assays or single assays with stated sampling times) Assays within recommended range

173

321

33

48

Overdose Postdose >lO mgA Postdose SlO but trough ~2 mgfl Total overdose

26 36 62

Underdose mgfl nt ose due to high serum concentrations Increased dose due to low serum concentrations

224

139 42162 (68%) ‘131139(53%)

x24 (42%)

#Only173(68%)of patients had interpretable assays, and these showed that 1139 of 173(SO%)of these patients were underdosed.

and Angus. Early results with the new poli a dramatic improvement in compliance wI dards of care. Of the first 60 patients audit (80%) received the correct initial dose (7 mg/k had satisfactory serum concentrations based on measurement of a single sample in the previous audit of 255 pati 32% had no levels and peak seru were <8 mgll for 80% of the rem

es%overtly sutco

ate %rea~e~t a

e data already discussed provide so ratification of trea%ment that is n be ideal, and one example of improving practice. H it is important to emphasize how difficult it %odetect subop%imal treatment. An audit of treatment of intraabdominal sepsis separa%ed pa-

Pharmacoeconomics analyzes the cos%san of trea%ment. Appreciation of %heprinciples of pharmacoeconomics in

re are an incr treatment were further divided into patients who remained on inappropriate treatment and those whose therapy was changed once the results of cul%uresbecame available, showing that early empirical treatment wi%happropria%e antimicrobials achieved

remainder of this supplement provide. us wi%h the basis for fur%her progress with respect to cephalosporins in general and cefotaxime in particular.

unit. J A~ti~ic~Qb Che~othe~ (in Classen DC, Evans IRS, Pestotnik RL, Burke JP (1992) The istration of ~~ti~ic~obia~s and the risk of surgicalwound infection. N Engl 1 Med 3265281-286. Culyer AJ (1973) Health Economics. London: Davey PG, Parker SE Orange @, Malek (1995) Prospective it of costs and outc ~og~ycos~de treatment and treatment ior Grammia. J ~~~i~ic~~b ~bem~the:r (in usch R (1983) Economics. New Yo

Economics. New Yor my G (1988) The Economics McGuire A, Henderson J, of Health Care. London: Routledge and Kegan Paul.

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