Cost-minimization in Health: Linezolid versus vancomycin with serum monitoring in patients with incipient renal failure – a simulation and real-life / Minimização de custos em Saúde: Linezolida versus vancomicina com monitoramento sérico em pacientes com insuficiência renal incipiente - uma simulação e vida real
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Brazilian Journal of Health Review |
Texto Completo: | https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/34925 |
Resumo: | Vancomycin serum levels (VSL) were measured to prevent dose-dependent side effects. However, the cost of VSL is high, therefore in some cases alternative antibacterial treatments, such as linezolid, can be used. The aim of this study was to perform an economic analysis of the cost of linezolid compared to vancomycin plus therapeutic drug monitoring. This is an ecological, retrospective, quantitative study, conducted in a Brazilian public university hospital. The study period was from January 2018 to January 2019. First part from January/18 - July/18 based on pre-linezolid data (T1) and another after the introduction of linezolid from August/18 - January/19 (T2). A breakeven analysis to vancomycin substitution was performed following 3 scenarios: (i) in all patients, (ii) in critically ill patients with renal failure or (iii) only in patients in hemodialysis. The DDD/1000-patients day, MRSA incidence, costs with VSL, as well as the costs of drugs (vancomycin and linezolid) and infusion kits were evaluated. Vancomycin was substituted in critically ill patients with renal failure from T1 to T2. The incidence of MRSA infections did not vary between T1 and T2. Vancomycin consume maintained constant (p=0.157); while linezolid consuming increased (0 DDD/1000PD versus 33.4 DDD/1000PD; p=0.002). Vancomycin and linezolid costs was lower in T1 than T2 (USD 9202,00 versus 11331,00; p=0.015). Linezolid implementation as a strategy to avoid vancomycin plus VSL was not cost-effective in critically ill patients with renal failure. More studies are needed to understand if linezolid implementation may be cost-effective in different scenarios. |
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Brazilian Journal of Health Review |
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Cost-minimization in Health: Linezolid versus vancomycin with serum monitoring in patients with incipient renal failure – a simulation and real-life / Minimização de custos em Saúde: Linezolida versus vancomicina com monitoramento sérico em pacientes com insuficiência renal incipiente - uma simulação e vida realVancomycinLinezolidAntimicrobial StewardshipEconomy.Vancomycin serum levels (VSL) were measured to prevent dose-dependent side effects. However, the cost of VSL is high, therefore in some cases alternative antibacterial treatments, such as linezolid, can be used. The aim of this study was to perform an economic analysis of the cost of linezolid compared to vancomycin plus therapeutic drug monitoring. This is an ecological, retrospective, quantitative study, conducted in a Brazilian public university hospital. The study period was from January 2018 to January 2019. First part from January/18 - July/18 based on pre-linezolid data (T1) and another after the introduction of linezolid from August/18 - January/19 (T2). A breakeven analysis to vancomycin substitution was performed following 3 scenarios: (i) in all patients, (ii) in critically ill patients with renal failure or (iii) only in patients in hemodialysis. The DDD/1000-patients day, MRSA incidence, costs with VSL, as well as the costs of drugs (vancomycin and linezolid) and infusion kits were evaluated. Vancomycin was substituted in critically ill patients with renal failure from T1 to T2. The incidence of MRSA infections did not vary between T1 and T2. Vancomycin consume maintained constant (p=0.157); while linezolid consuming increased (0 DDD/1000PD versus 33.4 DDD/1000PD; p=0.002). Vancomycin and linezolid costs was lower in T1 than T2 (USD 9202,00 versus 11331,00; p=0.015). Linezolid implementation as a strategy to avoid vancomycin plus VSL was not cost-effective in critically ill patients with renal failure. More studies are needed to understand if linezolid implementation may be cost-effective in different scenarios.Brazilian Journals Publicações de Periódicos e Editora Ltda.2021-08-24info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/3492510.34119/bjhrv4n4-275Brazilian Journal of Health Review; Vol. 4 No. 4 (2021); 17974-17987Brazilian Journal of Health Review; v. 4 n. 4 (2021); 17974-179872595-6825reponame:Brazilian Journal of Health Reviewinstname:Federação das Indústrias do Estado do Paraná (FIEP)instacron:BJRHporhttps://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/34925/pdfCopyright (c) 2021 Brazilian Journal of Health Reviewinfo:eu-repo/semantics/openAccessTuon, Felipe FranciscoPepes, AllanaOliveira, Dayana Dos SantosZequinao, TiagoCruz, June Alisson WestarbTelles, João Paulo2021-09-16T17:41:44Zoai:ojs2.ojs.brazilianjournals.com.br:article/34925Revistahttp://www.brazilianjournals.com/index.php/BJHR/indexPRIhttps://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/oai|| brazilianjhr@gmail.com2595-68252595-6825opendoar:2021-09-16T17:41:44Brazilian Journal of Health Review - Federação das Indústrias do Estado do Paraná (FIEP)false |
dc.title.none.fl_str_mv |
Cost-minimization in Health: Linezolid versus vancomycin with serum monitoring in patients with incipient renal failure – a simulation and real-life / Minimização de custos em Saúde: Linezolida versus vancomicina com monitoramento sérico em pacientes com insuficiência renal incipiente - uma simulação e vida real |
title |
Cost-minimization in Health: Linezolid versus vancomycin with serum monitoring in patients with incipient renal failure – a simulation and real-life / Minimização de custos em Saúde: Linezolida versus vancomicina com monitoramento sérico em pacientes com insuficiência renal incipiente - uma simulação e vida real |
spellingShingle |
Cost-minimization in Health: Linezolid versus vancomycin with serum monitoring in patients with incipient renal failure – a simulation and real-life / Minimização de custos em Saúde: Linezolida versus vancomicina com monitoramento sérico em pacientes com insuficiência renal incipiente - uma simulação e vida real Tuon, Felipe Francisco Vancomycin Linezolid Antimicrobial Stewardship Economy. |
title_short |
Cost-minimization in Health: Linezolid versus vancomycin with serum monitoring in patients with incipient renal failure – a simulation and real-life / Minimização de custos em Saúde: Linezolida versus vancomicina com monitoramento sérico em pacientes com insuficiência renal incipiente - uma simulação e vida real |
title_full |
Cost-minimization in Health: Linezolid versus vancomycin with serum monitoring in patients with incipient renal failure – a simulation and real-life / Minimização de custos em Saúde: Linezolida versus vancomicina com monitoramento sérico em pacientes com insuficiência renal incipiente - uma simulação e vida real |
title_fullStr |
Cost-minimization in Health: Linezolid versus vancomycin with serum monitoring in patients with incipient renal failure – a simulation and real-life / Minimização de custos em Saúde: Linezolida versus vancomicina com monitoramento sérico em pacientes com insuficiência renal incipiente - uma simulação e vida real |
title_full_unstemmed |
Cost-minimization in Health: Linezolid versus vancomycin with serum monitoring in patients with incipient renal failure – a simulation and real-life / Minimização de custos em Saúde: Linezolida versus vancomicina com monitoramento sérico em pacientes com insuficiência renal incipiente - uma simulação e vida real |
title_sort |
Cost-minimization in Health: Linezolid versus vancomycin with serum monitoring in patients with incipient renal failure – a simulation and real-life / Minimização de custos em Saúde: Linezolida versus vancomicina com monitoramento sérico em pacientes com insuficiência renal incipiente - uma simulação e vida real |
author |
Tuon, Felipe Francisco |
author_facet |
Tuon, Felipe Francisco Pepes, Allana Oliveira, Dayana Dos Santos Zequinao, Tiago Cruz, June Alisson Westarb Telles, João Paulo |
author_role |
author |
author2 |
Pepes, Allana Oliveira, Dayana Dos Santos Zequinao, Tiago Cruz, June Alisson Westarb Telles, João Paulo |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Tuon, Felipe Francisco Pepes, Allana Oliveira, Dayana Dos Santos Zequinao, Tiago Cruz, June Alisson Westarb Telles, João Paulo |
dc.subject.por.fl_str_mv |
Vancomycin Linezolid Antimicrobial Stewardship Economy. |
topic |
Vancomycin Linezolid Antimicrobial Stewardship Economy. |
description |
Vancomycin serum levels (VSL) were measured to prevent dose-dependent side effects. However, the cost of VSL is high, therefore in some cases alternative antibacterial treatments, such as linezolid, can be used. The aim of this study was to perform an economic analysis of the cost of linezolid compared to vancomycin plus therapeutic drug monitoring. This is an ecological, retrospective, quantitative study, conducted in a Brazilian public university hospital. The study period was from January 2018 to January 2019. First part from January/18 - July/18 based on pre-linezolid data (T1) and another after the introduction of linezolid from August/18 - January/19 (T2). A breakeven analysis to vancomycin substitution was performed following 3 scenarios: (i) in all patients, (ii) in critically ill patients with renal failure or (iii) only in patients in hemodialysis. The DDD/1000-patients day, MRSA incidence, costs with VSL, as well as the costs of drugs (vancomycin and linezolid) and infusion kits were evaluated. Vancomycin was substituted in critically ill patients with renal failure from T1 to T2. The incidence of MRSA infections did not vary between T1 and T2. Vancomycin consume maintained constant (p=0.157); while linezolid consuming increased (0 DDD/1000PD versus 33.4 DDD/1000PD; p=0.002). Vancomycin and linezolid costs was lower in T1 than T2 (USD 9202,00 versus 11331,00; p=0.015). Linezolid implementation as a strategy to avoid vancomycin plus VSL was not cost-effective in critically ill patients with renal failure. More studies are needed to understand if linezolid implementation may be cost-effective in different scenarios. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-08-24 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/34925 10.34119/bjhrv4n4-275 |
url |
https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/34925 |
identifier_str_mv |
10.34119/bjhrv4n4-275 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/34925/pdf |
dc.rights.driver.fl_str_mv |
Copyright (c) 2021 Brazilian Journal of Health Review info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2021 Brazilian Journal of Health Review |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Brazilian Journals Publicações de Periódicos e Editora Ltda. |
publisher.none.fl_str_mv |
Brazilian Journals Publicações de Periódicos e Editora Ltda. |
dc.source.none.fl_str_mv |
Brazilian Journal of Health Review; Vol. 4 No. 4 (2021); 17974-17987 Brazilian Journal of Health Review; v. 4 n. 4 (2021); 17974-17987 2595-6825 reponame:Brazilian Journal of Health Review instname:Federação das Indústrias do Estado do Paraná (FIEP) instacron:BJRH |
instname_str |
Federação das Indústrias do Estado do Paraná (FIEP) |
instacron_str |
BJRH |
institution |
BJRH |
reponame_str |
Brazilian Journal of Health Review |
collection |
Brazilian Journal of Health Review |
repository.name.fl_str_mv |
Brazilian Journal of Health Review - Federação das Indústrias do Estado do Paraná (FIEP) |
repository.mail.fl_str_mv |
|| brazilianjhr@gmail.com |
_version_ |
1797240065913520128 |