Multiresistant bacteria and current therapy - the economical side of the story

摘要: Severe infections with multiresistant bacteria (MRB) are a medical challenge and financial burden for hospitals. The adequate antibiotic therapy is key issue in management. Several major cost drivers have been identified. Remarkably drug acquisition costs not necessarily included. Most significant the length of stay hospital, hours mechanical ventilation time treated on an intensive care unit. In systematic review literature following aspects were investigated: - Do generic treatment strategies contribute savings? Are there specific results recent antibiotics? Early effective antimicrobial treatment, switch from i.v. to oral therapy, adjusted duration adherence guidelines found be successful strategies. Looking at antibiotics, best evidence cost-effectiveness Linezolid cSSTI as well HAP. Daptomycin shows good economic bloodstream infections, so possibly being cost-effective alternative vancomycin. tigecycline published data show neither higher nor savings compared imipeneme. Doripenem one newest options has proven highly cost-saving HAP when imipenem. However, most analyses based pharmacoeconomic modelling rather than directly analysing trial or real life clinical populations. Using modern antibiotics whole more expensive using established therapies. Modern sometimes even cost-saving. This especially true if initiated early possible.