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Abstract

Vol.54 No.2 March 2006

Analyses of treatment days and cost of panipenem/betamipron and cefozopran therapy in the treatment of respiratory tract infections

Keisuke Sunakawa1), Makoto Kobayashi2,3), Hajime Goto4) and Koichi Wada5)

1)Department of Infectious Diseases, Kitasato University School of Medicine,
1-15-1 Kitasato, Sagamihara, Kanagawa, Japan
2)Healtheconomics Research Group, Crecon Research and Consulting Inc.
3)Department of Medical Information and Medical Science, Nagoya University Graduate School of Medicine
4)The First Department of Internal Medicine, Kyorin University School of Medicine
5)Department of Internal Medicine, Toyano Chuo Hospital

Abstract

The purpose of this study was to evaluate the number of treatment days in panipenem/betamipron (PAPM/BP) and cefozopran hydrochloride (CZOP) regimens, and the pharmacoeconomics of these drugs for the initial treatment of moderate or severe respiratory tract infections. On admission, patients with bacterial pneumoniae, community-acquired pneumonia, or acute secondary exacerbation of chronic pulmonary diseases were allocated randomly to a PAPM/BP or a CZOP therapy group. The number of days of parenteral antibacterial agent (including switched or concomitant ones) therapy and the number of days from admission until all body temperature, CRP and WBC results recovered to their standard values up to 29 days were evaluated. The total treatment cost during hospitalization and during parenteral antibacterial agent therapy were also estimated.
Ninety-two cases (PAPM/BP therapy group, 45 cases; CZOP therapy group, 47 cases) were examined for efficacy and included in the pharmacoeconomic analyses; nonbacterial infection cases were excluded from the 120 enrolled cases. The number of days of parenteral antibacterial agent therapy was 8.0 for the PAPM/BP group and 10.0 for the CZOP group (median, p=0.1480, Wilcoxon rank sum test). The number of days from admission until recovery of the three above-mentioned symptoms was 6.0 for the PAPM/BP group and 8.0 for the CZOP group (median, p=0.0268). Both time periods were shorter numbers for days for the PAPM/BP group than for the CZOP group.
The mean total treatment cost (including the costs of hospitalization, PAPM/BP or CZOP, switched and concomitant antibacterial agents, treatment for drug-related adverse events, and clinical tests) during hospitalization was ¥262,862 for the PAPM/BP group and ¥276,720 for the CZOP group (variance; ¥-13,858). The total treatment cost of parenteral antibacterial agent therapy was ¥218,604 for the PAPM/BP group and ¥236,421 for the CZOP group (variance; ¥-17,817). The cost was lower for the PAPM/BP group for both comparisons. Although the cost of PAPM/BP itself was higher than that of CZOP, in cost of other items was lower in PAPM/BP group.
The efficacy rates at the end of PAPM/BP or CZOP therapy were 97.8% (44/45) and 87.2% (41/47), respectively. The frequency of drug-related adverse events was 22.0% (13/59) and 32.2% (19/59), respectively. No severe drug-related adverse events occurred in either group, and all the events recovered or improved with the cessation or continuation of the drugs.
In conclusion, PAPM/BP therapy for the initial treatment of moderate or severe respiratory infectious diseases enable a shorter hospitalization and a lower treatment cost than CZOP therapy.

Key word

respiratory tract infection, panipenem/betamipron, cefozopran, treatment duration, pharmacoeconomics

Received

October 21, 2005

Accepted

January 10, 2006

Jpn. J. Chemother. 54 (2): 111-124, 2006