Economic costs are an important consideration when developing public health policies, particularly in countries like China with a large population and restricted resources. Therefore cost-effectiveness analyses are integral for helping decide optimal therapeutic regimens. A recent Chinese study investigated two different levofloxacin regimens in 108 elderly patients with acute lower respiratory tract infections (LRTI), a group with a high morbidity and mortaｈlity. Hospitalised patients over 60 years of age were randomised to receive 10 days of either intravenous infusion (Group A: 200mg IV, bid) versus sequential intravenous and oral therapy (Group B: 200mg IV, bid for 5 days, 200mg oral bid 5 days). Demographic characteristics were the same for both groups.

Results confirmed that Groups A and B had cure rates of 61.1% and 59.3%, clinical efficacy rates (recovery plus significant improvement) of 88.9% and 83.3%, and bacterial eradication rates of 96.3% and 92.6%. There were no statistical differences between the two groups. Adverse reactions were reported in 7.4% and 3.7%, respectively. Assessment of treatment costs included direct costs (cost of medicine, administration, examination and hospitalisation costs) but did not include indirect costs (loss of salary, etc.). The cost associated with intravenous therapy in Group A was 1,588 RMB compared to 150 RMB for the sequential therapy group.

As there were no significant differences in clinical efficacy, incidence of adverse reactions, and eradication rates, the researchers concluded that sequential therapy was more cost- effective compared to the intravenous regimen (17.86 vs. 13.81, P<0.05). Sensitivity analyses also showed that patients treated sequentially could go home when stable and continue treatment as outpatients, which would further reduce treatment costs as well as the likelihood of developing hospital-associated complications. Researchers concluded that sequential levofloxacin is cost-effective for treating LRTI in the elderly.

PMID: 28442897

Clin Interv Aging. 2017 Apr 12;12:673-678. doi: 10.2147/CIA.S127009. eCollection 2017.

Source: https://www.ncbi.nlm.nih.gov/pubmed/28442897?dopt=Abstract