Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio.
Am J Perinatol. 2019 Jan;36(1):105-110. doi: 10.1055/s-0038-1667369. Epub 2018 Aug 13.
To quantify the potential cost savings if azithromycin is substituted for erythromycin in women with preterm premature rupture of membranes (PPROM).
Secondary analysis of a multicentered study investigating magnesium sulfate for the prevention of cerebral palsy in premature infants. All patients with PPROM who received antibiotics for prophylaxis were included in the analysis. The number of expected doses each patient would have received was calculated for erythromycin, multidose azithromycin, and single-dose azithromycin regimens accounting for latency from PPROM to delivery. The wholesale acquisition cost was used to calculate the expected cost of each regimen.
There were 981 PPROM patients who received a penicillin class antibiotic and erythromycin. Patients would have received 7,528 intravenous doses and 10,194 oral doses of erythromycin at a combined cost of $357,169. In comparison, patients would have received 6,422 and 3,942 doses at a cost of $15,669 and $9,574 for the multidose and single-dose azithromycin regimens respectively, which represents a more than 95% cost reduction for either regimen compared with erythromycin.
The use of azithromycin substituted for erythromycin in the standard antibiotic regimen of women with PPROM represents a potential for substantial cost reduction.
如果在胎膜早破（PPROM）的女性中用阿奇霉素替代红霉素，将量化潜在的成本节约。
对一项多中心研究的二次分析，该研究调查了硫酸镁在预防早产儿脑瘫中的作用。所有接受抗生素预防的 PPROM 患者均纳入分析。计算了红霉素、多剂量阿奇霉素和单剂量阿奇霉素方案中每位患者预期接受的剂量数，考虑了从 PPROM 到分娩的潜伏期。使用批发采购成本来计算每个方案的预期成本。
有 981 例 PPROM 患者接受了青霉素类抗生素和红霉素治疗。患者将接受 7528 次静脉注射剂量和 10194 次口服剂量的红霉素，总费用为 357169 美元。相比之下，多剂量和单剂量阿奇霉素方案的患者将分别接受 6422 次和 3942 次剂量，费用分别为 15669 美元和 9574 美元，与红霉素相比，这两种方案的成本降低了 95%以上。
在 PPROM 女性的标准抗生素方案中使用阿奇霉素替代红霉素，可能会带来显著的成本节约。
