Cost-minimization analysis of oral versus intravenous antibiotic treatment for Klebsiella pneumoniae liver abscess

A cost-minimization analysis was conducted for Klebsiella pneumoniae liver abscess (KLA) patients enrolled in a randomized controlled trial which found oral ciprofloxacin to be non-inferior to intravenous (IV) ceftriaxone in terms of clinical outcomes. Healthcare service utilization and cost data we...

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Published in:	Scientific reports 2023-06, Vol.13 (1), p.9774-9774, Article 9774
Main Authors:	Yoong, Joanne, Yuen, Kah Hung, Molton, James S, Ding, Ying, Cher, Boon Piang, Chan, Monica, Kalimuddin, Shirin, Oon, Jolene, Young, Barnaby, Low, Jenny, Salada, Brenda M A, Lee, Tau Hong, Wijaya, Li Min, Fisher, Dale, Izharuddin, Ezlyn, Wei, Yuan, Phillips, Rachel, Moorakonda, Rajesh, Lye, David C, Archuleta, Sophia
Format:	Article
Language:	eng
Subjects:	Abscesses Administration, Oral Adult Anti-Bacterial Agents - therapeutic use Antibiotics Ceftriaxone Ceftriaxone - therapeutic use Ciprofloxacin Ciprofloxacin - therapeutic use Costs Costs and Cost Analysis Health care Humans Intravenous administration Klebsiella pneumoniae Liver Liver Abscess - drug therapy Medical records Patients Statistical analysis
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Summary:	A cost-minimization analysis was conducted for Klebsiella pneumoniae liver abscess (KLA) patients enrolled in a randomized controlled trial which found oral ciprofloxacin to be non-inferior to intravenous (IV) ceftriaxone in terms of clinical outcomes. Healthcare service utilization and cost data were obtained from medical records and estimated from self-reported patient surveys in a non-inferiority trial of oral ciprofloxacin versus IV ceftriaxone administered to 152 hospitalized adults with KLA in Singapore between November 2013 and October 2017. Total costs were evaluated by category and payer, and compared between oral and IV antibiotic groups over the trial period of 12 weeks. Among the subset of 139 patients for whom cost data were collected, average total cost over 12 weeks was $16,378 (95% CI, $14,620-$18,136) for the oral ciprofloxacin group and $20,569 (95% CI, $18,296-$22,842) for the IV ceftriaxone group, largely driven by lower average outpatient costs, as the average number of outpatient visits was halved for the oral ciprofloxacin group. There were no other statistically significant differences, either in inpatient costs or in other informal healthcare costs. Oral ciprofloxacin is less costly than IV ceftriaxone in the treatment of Klebsiella liver abscess, largely driven by reduced outpatient service costs.Trial registration: ClinicalTrials.gov Identifier NCT01723150 (7/11/2012).
ISSN:	2045-2322 2045-2322