A randomised, multicentre study of ceftriaxone versus standard therapy in the treatment of lower respiratory tract infections

In this study the efficacy and cost-effectiveness of i.v. ceftriaxone 1 g once daily (CTX) was compared with standard i.v. antibiotic treatment (STD) for lower respiratory tract infections (LRTI). STD was given according to the guidelines of the American Thoracic Society and consisted of either cefu...

Full description

Saved in:

Bibliographic Details
Published in:	International journal of antimicrobial agents Vol. 12; no. 2; pp. 121 - 127
Main Authors:	de Klerk, G.J., van Steijn, J.H.M., Lobatto, S., Jaspers, C.A.J.J., van Veldhuizen, W.C.J., Hensing, C.A.J., Bunnik, M.C.M., Geraedts, W.H., Dofferhof, A.S.M., Van Den Berg, J., Melis, J.H.J.M., Hoepelman, A.I.M.
Format:	Journal Article
Language:	English
Published:	London Elsevier B.V 01-07-1999 Amsterdam Elsevier New York, NY
Subjects:	Adolescent Adult Aged Aged, 80 and over Amoxicillin-Potassium Clavulanate Combination - economics Amoxicillin-Potassium Clavulanate Combination - therapeutic use Anti-Bacterial Agents - economics Anti-Bacterial Agents - therapeutic use Antibacterial agents Antibiotics. Antiinfectious agents. Antiparasitic agents Biological and medical sciences Bronchitis - drug therapy Bronchitis - microbiology Ceftriaxone Ceftriaxone - economics Ceftriaxone - therapeutic use Cephalosporins - economics Cephalosporins - therapeutic use Chronic Disease Drug Administration Schedule Drug Costs Female Follow-Up Studies Humans Lower respiratory tract infections Male Medical sciences Middle Aged Pharmacology. Drug treatments Pneumonia Pneumonia - drug therapy Pneumonia - microbiology Standard therapy Streptococcus pneumoniae Lower respiratory tract infections Standard therapy Pneumonia Ceftriaxone Human Intravenous administration Respiratory disease β-Lactams Oral administration Respiratory system Infection Antibiotic Chemotherapy Cephalosporin derivatives Randomization Treatment Health economy Antibacterial agent Comparative study Cost efficiency analysis
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	In this study the efficacy and cost-effectiveness of i.v. ceftriaxone 1 g once daily (CTX) was compared with standard i.v. antibiotic treatment (STD) for lower respiratory tract infections (LRTI). STD was given according to the guidelines of the American Thoracic Society and consisted of either cefuroxime 1500 mg three times daily (q8h), amoxicillin/clavulanic acid 1200 mg q8h or ceftriaxone 2 g once daily; each with or without a macrolide. After a minimum of 5 days i.v. therapy, patients could be switched to oral therapy. One hundred patients were enrolled in the study; 52 patients received CTX and 48 STD. Groups were comparable with respect to demographic and baseline characteristics. Seventy patients had a confirmed diagnosis of pneumonia. Twenty-nine patients had a severe type I exacerbation of chronic bronchitis. In one patient the diagnosis of LRTI could not be confirmed. In approximately 50% of the patients a microbiological diagnosis could be made. The most important isolated pathogens from sputum and blood were (positive blood cultures in brackets): Streptococcus pneumoniae 14 (9) and Haemophilus influenzae 16. Mean duration of i.v. therapy was 7.4 days in both groups. Average duration of hospitalisation was 15.0 days for CTX patients and 15.9 days for STD patients. Overall cure and improvement rate at the end of treatment was 47 (90%) for patients receiving ceftriaxone 1 g compared to 37 (77%) for patients receiving standard therapy. Pathogens were eradicated or presumed to be eradicated in 84% of the CTX patients and in 76% of the STD patients. Mean total costs per treatment were lower for CTX than for STD treatment: NLG 169 versus 458. These results show, that i.v. ceftriaxone 1 g once daily is as effective as standard therapy in the treatment of LRTI and that its use reduces treatment costs, in view of the multiple daily dosing regimens of most standard therapies.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-News-3
ISSN:	0924-8579 1872-7913
DOI:	10.1016/S0924-8579(99)00037-0