Barwon Health, Geelong Hospital, Ryrie Street, Geelong, Victoria 3220, Australia.
Int Health. 2012 Jun;4(2):123-7. doi: 10.1016/j.inhe.2011.12.005.
Mycobacterium ulcerans infection results in significant disfiguring morbidity, and treatment is expensive. To estimate the cost of treatment in the antibiotic era, a retrospective study of 71 patients diagnosed and treated for M. ulcerans in the Bellarine Peninsula (Victoria, Australia) between 1998 and 2006 was performed. Patients were categorised into minor single episode infection, major single episode infection and recurrent disease. Data were collected on each treatment cost component. To determine the change from costs in the pre-antibiotic era, mean direct costs were compared with those from a study in a nearby region between 1991 and 1998. All costs were in Australian dollars in 2006-2007 prices. The mean overall cost was $6181 per episode, with the highest cost components being hospitalisation (mean $3977; 63%) and surgeon fees ($949; 12%). Treatment costs per episode increased significantly from minor infection ($2235) to major infection ($6338) to recurrent disease ($13 372). Compared with the pre-antibiotic era, costs have significantly decreased, with a 52% reduction in overall cost per episode, driven mainly by a reduction in hospitalisation costs. Therefore, earlier diagnosis and treatment of M. ulcerans, including the use of outpatient-based oral antibiotic regimens, has the potential to reduce the cost of treatment.
溃疡分枝杆菌感染会导致严重的毁容发病率，且治疗费用昂贵。为了评估抗生素时代的治疗成本，我们对 1998 年至 2006 年间在澳大利亚维多利亚州贝拉里半岛诊断和治疗溃疡分枝杆菌的 71 例患者进行了回顾性研究。患者分为轻度单发性感染、重度单发性感染和复发性疾病。收集了每例患者的治疗成本构成数据。为了确定从抗生素前时代的成本变化，我们将直接成本的平均值与附近地区 1991 年至 1998 年的研究进行了比较。所有成本均按 2006-2007 年的澳元价格计算。平均每次发作的总费用为 6181 澳元，其中最高的费用构成部分是住院费用（平均 3977 澳元，占 63%）和外科医生费用（949 澳元，占 12%）。每次发作的治疗费用从轻度感染（2235 澳元）到重度感染（6338 澳元）再到复发性疾病（13372 澳元）显著增加。与抗生素前时代相比，成本显著降低，每次发作的总费用降低了 52%，这主要是由于住院费用的降低。因此，早期诊断和治疗溃疡分枝杆菌，包括使用门诊口服抗生素方案，有可能降低治疗成本。
