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

Viriya Hantrakun; Wirongrong Chierakul; Ploenchan Chetchotisakd; Siriluck Anunnatsiri; Bart J. Currie; Sharon J. Peacock; Nicholas P.J. Day; Phaik Cheah; Direk Limmathurotsakul; Yoel Lubell

doi:10.1093/trstmh/trv002

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

Viriya Hantrakun, Wirongrong Chierakul, Ploenchan Chetchotisakd, Siriluck Anunnatsiri, Bart J. Currie, Sharon J. Peacock, Nicholas P.J. Day, Phaik Cheah, Direk Limmathurotsakul, Yoel Lubell

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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.

Original language	English
Pages (from-to)	416-418
Number of pages	3
Journal	Transactions of the Royal Society of Tropical Medicine and Hygiene
Volume	109
Issue number	6
DOIs	https://doi.org/10.1093/trstmh/trv002
Publication status	Published - 2015

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Hantrakun, V., Chierakul, W., Chetchotisakd, P., Anunnatsiri, S., Currie, B. J., Peacock, S. J., Day, N. P. J., Cheah, P., Limmathurotsakul, D., & Lubell, Y. (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. https://doi.org/10.1093/trstmh/trv002

@article{c0c6e397824e428781b8d0d84fe40946,

title = "Cost-effectiveness analysis of parenteral antimicrobials for acute melioidosis in Thailand",

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.",

keywords = "Antimicrobials, Ceftazidime, Cost-effective treatment, Meliodosis, Meropenem, Northeast Thailand",

author = "Viriya Hantrakun and Wirongrong Chierakul and Ploenchan Chetchotisakd and Siriluck Anunnatsiri and Currie, {Bart J.} and Peacock, {Sharon J.} and Day, {Nicholas P.J.} and Phaik Cheah and Direk Limmathurotsakul and Yoel Lubell",

note = "Corrigendum: When the original article was published part of one of the author's names was omitted in the originally published paper. Phaik Cheah should appear as Phaik Yeong Cheah. This has now been corrected with erratum - https://doi.org/10.1093/trstmh/trv093",

year = "2015",

doi = "10.1093/trstmh/trv002",

language = "English",

volume = "109",

pages = "416--418",

journal = "Transactions of the Royal Society of Tropical Medicine and Hygiene",

issn = "0035-9203",

publisher = "Elsevier",

number = "6",

}

Hantrakun, V, Chierakul, W, Chetchotisakd, P, Anunnatsiri, S, Currie, BJ, Peacock, SJ, Day, NPJ, Cheah, P, Limmathurotsakul, D & Lubell, Y 2015, 'Cost-effectiveness analysis of parenteral antimicrobials for acute melioidosis in Thailand', Transactions of the Royal Society of Tropical Medicine and Hygiene, vol. 109, no. 6, pp. 416-418. https://doi.org/10.1093/trstmh/trv002

TY - JOUR

T1 - Cost-effectiveness analysis of parenteral antimicrobials for acute melioidosis in Thailand

AU - Hantrakun, Viriya

AU - Chierakul, Wirongrong

AU - Chetchotisakd, Ploenchan

AU - Anunnatsiri, Siriluck

AU - Currie, Bart J.

AU - Peacock, Sharon J.

AU - Day, Nicholas P.J.

AU - Cheah, Phaik

AU - Limmathurotsakul, Direk

AU - Lubell, Yoel

N1 - Corrigendum: When the original article was published part of one of the author's names was omitted in the originally published paper. Phaik Cheah should appear as Phaik Yeong Cheah. This has now been corrected with erratum - https://doi.org/10.1093/trstmh/trv093

PY - 2015

Y1 - 2015

N2 - 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.

AB - 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.

KW - Antimicrobials

KW - Ceftazidime

KW - Cost-effective treatment

KW - Meliodosis

KW - Meropenem

KW - Northeast Thailand

UR - http://www.scopus.com/inward/record.url?scp=84939524187&partnerID=8YFLogxK

U2 - 10.1093/trstmh/trv002

DO - 10.1093/trstmh/trv002

M3 - Article

VL - 109

SP - 416

EP - 418

JO - Transactions of the Royal Society of Tropical Medicine and Hygiene

JF - Transactions of the Royal Society of Tropical Medicine and Hygiene

SN - 0035-9203

IS - 6

ER -

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

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