De Cock E, Sorensen S, Levrat F, Besnier J-M, Dupon M, Guery B, Duttagupta S
United BioSource Corporation, Health Care Analytics Group, Carrer Torrent del Remei 5-11, 4 degrees -2 feminine, Barcelona 08023, Spain.
Med Mal Infect. 2009 May;39(5):330-40. doi: 10.1016/j.medmal.2009.01.005. Epub 2009 Mar 21.
Studies have shown similar clinical cure rates and shorter length of hospitalization when using linezolid compared to vancomycin in patients with complicated skin and soft-tissue infections due to suspected or proven methicillin-resistant Staphylococcus aureus (MRSA).
This study had for aim to compare the cost-effectiveness of linezolid versus vancomycin in French healthcare settings.
A decision-analytic model followed an average patient from the initiation of an empiric treatment until cure, death or second-line treatment failure. A clinical data probability was obtained from clinical trials, resource utilization data (including treatment duration and length of hospitalization) and prevalence of MRSA was obtained from a Delphi panel, and costs from published sources.
First-line cure rate for linezolid-treated patients was 90.7% versus 85.5% for vancomycin; the total cure rates after two lines of treatment were 98.5% and 98.0%, respectively. The average total cost was 7,778euro for linezolid versus 8,777euro for vancomycin. The mean estimated length of hospitalization after two lines of treatment was 10.7 days for linezolid versus 13.3 days for vancomycin. The increased effectiveness and reduced cost lead to more frequent prescription. This did not change after one-way sensitivity analyses.
Linezolid may be considered as a cost-effective treatment for patients with complicated skin and soft-tissue infections suspected to be MRSA related in France.
研究表明,对于疑似或确诊为耐甲氧西林金黄色葡萄球菌(MRSA)引起的复杂性皮肤和软组织感染患者,与使用万古霉素相比,使用利奈唑胺时临床治愈率相似且住院时间更短。
本研究旨在比较利奈唑胺与万古霉素在法国医疗环境中的成本效益。
一个决策分析模型跟踪了一名从经验性治疗开始直至治愈、死亡或二线治疗失败的普通患者。临床数据概率来自临床试验,资源利用数据(包括治疗持续时间和住院时间)以及MRSA的患病率来自德尔菲小组,成本来自已发表的资料。
利奈唑胺治疗患者的一线治愈率为90.7%,而万古霉素为85.5%;经过两线治疗后的总治愈率分别为98.5%和98.0%。利奈唑胺的平均总成本为7778欧元,而万古霉素为8777欧元。两线治疗后的平均估计住院时间,利奈唑胺为10.7天,而万古霉素为13.3天。有效性提高和成本降低导致更频繁的处方。单向敏感性分析后这一情况未改变。
在法国,对于疑似与MRSA相关的复杂性皮肤和软组织感染患者,利奈唑胺可被视为一种具有成本效益的治疗方法。