Lodise Thomas, Rodriguez Mauricio, Chitra Surya, Wright Kelly, Patel Nimish
Albany College of Pharmacy and Health Sciences, Albany, NY 12208, USA.
Paratek Pharmaceuticals, Inc., King of Prussia, PA 19406, USA.
Antibiotics (Basel). 2021 Oct 1;10(10):1195. doi: 10.3390/antibiotics10101195.
Approximately 3% of hospitalized patients with community-acquired bacterial pneumonia (CABP) develop healthcare-associated infection (HCA-CDI). The validated Davis risk score (DRS) indicates that patients with a DRS ≥ 6 are at an increased risk of 30-day HCA-CDI. In the phase 3 OPTIC CABP study, 14% of CABP patients with DRS ≥ 6 who received moxifloxacin developed CDI vs. 0% for omadacycline. This study assessed the potential economic impact of substituting current guideline-concordant CABP inpatient treatments with omadacycline in hospitalized CABP patients with a DRS ≥ 6 across US hospitals.
A deterministic healthcare-decision analytic model was developed. The model population was hospitalized adult CABP patients with a DRS ≥ 6 across US hospitals (100,000 patients). In the guideline-concordant arm, 14% of CABP patients with DRS ≥ 6 were assumed to develop an HCA-CDI, each costing USD 20,100. In the omadacycline arm, 5 days of therapy was calculated for the entire model population.
The use of omadacycline in place of guideline-concordant CABP inpatient treatments for CABP patients with DRS ≥ 6 was estimated to result in cost savings of USD 55.4 million annually across US hospitals.
The findings of this simulated model suggest that prioritizing the use of omadacycline over current CABP treatments in hospitalized CABP with a DRS ≥ 6 may potentially reduce attributable HCA-CDI costs. The findings are not unique to omadacycline and could be applied to any antibiotic that confers a lower risk of HCA-CDI relative to current CABP inpatient treatments.
社区获得性细菌性肺炎(CABP)住院患者中约3%会发生医疗相关感染(HCA-CDI)。经过验证的戴维斯风险评分(DRS)表明,DRS≥6的患者发生30天HCA-CDI的风险增加。在3期OPTIC CABP研究中,接受莫西沙星治疗的DRS≥6的CABP患者中有14%发生了CDI,而接受奥玛环素治疗的这一比例为0%。本研究评估了在美国各医院中,用奥玛环素替代当前符合指南的CABP住院治疗方案,对DRS≥6的住院CABP患者可能产生的经济影响。
建立了一个确定性医疗决策分析模型。模型人群为美国各医院中DRS≥6的成年CABP住院患者(100,000例患者)。在符合指南的治疗组中,假设DRS≥6的CABP患者中有14%发生HCA-CDI,每例成本为20,100美元。在奥玛环素治疗组中,为整个模型人群计算了5天的治疗时间。
估计在美国各医院中,用奥玛环素替代符合指南的CABP住院治疗方案,用于DRS≥6的CABP患者,每年可节省成本5540万美元。
该模拟模型的结果表明,在DRS≥6的住院CABP患者中,优先使用奥玛环素而非当前的CABP治疗方案,可能会降低可归因的HCA-CDI成本。这些发现并非奥玛环素所独有,可应用于任何相对于当前CABP住院治疗方案而言HCA-CDI风险较低的抗生素。