Abstract

COST-EFFECTIVE ANALYSIS AND SAFETY OF COMMONLY PRESCRIBED ANTIBIOTICS IN LOWER RESPIRATORY TRACT INFECTION IN A TERTIARY CARE HOSPITAL

Asha Ann Joseph*, Cimija James, Shilpa C. Raj, Basavaraj K. Nanjwade, Anusha Sudulaguntla

ABSTRACT

Objective: To investigate the cost effectiveness and safety of currently used antibiotic regimens in the treatment of lower respiratory tract infections. Methodology: Data was collected prospectively for a period of six months. The demographic data and therapeutic details of antibiotics were collected from patients with LRTI. The CORB score and CRP value was used to assess the disease severity and the efficacy of antibiotic treatment. The adverse drug reactions have been classified using Naranjo’s causality assessment scale. The summarized data was entered into the worksheet in Microsoft Excel. Results: 154 Patients were enrolled in the study. The most commonly prescribed antibiotic was Levofloxacin (28%) followed by amoxicillin- clavulonate (27%) then Cefpodoxime (23.3%) and the least prescribed antibiotic was azithromycin (22%). In this study we found that the most cost-effective antibiotic in LRTI is Levofloxacin. The total number of ADRs observed were 12 (7.79%) out 154 cases. The therapeutic category of antibiotic implicated to cause most adverse drug reactions was found to be Cefpodoxime 4 (33.3%). Conclusions: The prevalence of LRTIs has increased over time and an additional hundred million people worldwide are expected to develop LRTI by the year 2025. The primary goal is to cure infection where antibiotics play an inevitable role. Since antibiotics account for a huge part of all hospital pharmacy budgets, cost-effective analysis of antibiotics should be used assessing different costs and health outcomes when decisions on individual treatment plan has to be made. Moreover, Adverse Drug Reactions to antibiotics are common and some of them lead to increased healthcare cost due to increased length of hospital stay. Therefore, physicians need to assess whether a specific antibiotic treatment justify its costs especially in patients with low socio-economic status.

Keywords: LRTI, Antibiotics, Cost-effectiveness, ADR.