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Title: Cost-effectiveness analysis of parenteral antimicrobials for acute melioidosis in Thailand
Authors: Viriya Hantrakun
Wirongrong Chierakul
Ploenchan Chetchotisakd
Siriluck Anunnatsiri
Bart J. Currie
Sharon J. Peacock
Nicholas P.J. Day
Phaik Cheah
Direk Limmathurotsakul
Yoel Lubell
Mahidol University
Khon Kaen University
Royal Darwin Hospital
University of Cambridge
Nuffield Department of Clinical Medicine
Keywords: Immunology and Microbiology
Issue Date: 1-Jan-2015
Citation: Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.109, No.6 (2015), 416-418
Abstract: © The Author 2015. Background: Melioidosis is a common community-acquired infectious disease in northeast Thailand associated with overall mortality of approximately 40% in hospitalized patients, and over 70% in severe cases. Ceftazidime is recommended for parenteral treatment in patients with suspected melioidosis. Meropenem is increasingly used but evidence to support this is lacking. Methods: A decision tree was used to estimate the cost-effectiveness of treating non-severe and severe suspected acute melioidosis cases with either ceftazidime or meropenem. Results: Empirical treatment with meropenem is likely to be cost-effective providing meropenem reduces mortality in severe cases by at least 9% and the proportion with subsequent culture-confirmed melioidosis is over 20%. Conclusions: In this context, treatment of severe cases with meropenem is likely to be cost-effective, while the evidence to support the use of meropenem in non-severe suspected melioidosis is not yet available.
ISSN: 18783503
Appears in Collections:Scopus 2011-2015

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