Publication: Cost-effectiveness analysis of parenteral antimicrobials for acute melioidosis in Thailand
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Issued Date
2015-01-01
Resource Type
ISSN
18783503
00359203
00359203
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2-s2.0-84939524187
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Mahidol University
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SCOPUS
Bibliographic Citation
Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.109, No.6 (2015), 416-418
Suggested Citation
Viriya Hantrakun, Wirongrong Chierakul, Ploenchan Chetchotisakd, Siriluck Anunnatsiri, Bart J. Currie, Sharon J. Peacock, Nicholas P.J. Day, Phaik Cheah, Direk Limmathurotsakul, Yoel Lubell Cost-effectiveness analysis of parenteral antimicrobials for acute melioidosis in Thailand. Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.109, No.6 (2015), 416-418. doi:10.1093/trstmh/trv002 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/36171
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Title
Cost-effectiveness analysis of parenteral antimicrobials for acute melioidosis in Thailand
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.