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
SN - 0035-9203
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
IS - 6
ER -