Cost-effectiveness analysis of ceftazidime-levofloxacin and cefotaxime-erythromycin as empirical antibiotic combinations in respiratory infection-induced sepsis

Objective: Pharmacoeconomics has become an important consideration in the selection of therapies, including in patients with sepsis caused by respiratory infection. The aim of this study was to determine the most cost-effective antibiotic combination for respiratory infection-induced sepsis at a public hospital in Bandung, Indonesia. Methods: This retrospective observational study was conducted at one of the public hospitals in Bandung. Two interventions were analyzed: (I1) Ceftazidime-levofloxacin and (I2) cefotaxime-erythromycin; and compared to the major treatment (I0, the use of other antibiotic combinations). Data were collected from the medical records of inpatients with respiratory infection-induced sepsis from 2010 to 2012. Health-care perspective was applied by considering only direct medical costs, which were calculated from a variable (drug, administrative, and treatment cost) and fixed cost (hospitalization). Results: Comparing with I0, net cost per life saved was calculated to be $3,350 (I1) and $1,589 (I2). Number of patients survived was considered to be the most significant parameter on affecting the calculation of net cost per life saved. Conclusion: I2 was more cost effective than I1, compared to I0