Oral versus i.v. antibiotics for community-acquired pneumonia in children: a cost-minimisation analysis - PubMed (original) (raw)

Randomized Controlled Trial

doi: 10.1183/09031936.00087209. Epub 2009 Aug 28.

Affiliations

• PMID: 19717479
• DOI: 10.1183/09031936.00087209

Free article

Randomized Controlled Trial

Oral versus i.v. antibiotics for community-acquired pneumonia in children: a cost-minimisation analysis

P K Lorgelly et al. Eur Respir J. 2010 Apr.

Free article

Abstract

Community-acquired pneumonia represents a high financial burden to healthcare providers. This manuscript seeks to estimate and compare the costs of treating children hospitalised with community-acquired pneumonia, with oral and intravenous antibiotics, thus determining which treatment is cost minimising. A cost-minimisation analysis was undertaken alongside a randomised controlled non-blinded equivalence trial. 232 children (from eight paediatric centres in England) diagnosed with pneumonia, who required admission to hospital, were randomised to receive oral amoxicillin or i.v. benzyl penicillin. The analysis considered the cost to the health service, patients and society, from pre-admission until the child was fully recovered. Oral amoxicillin and i.v. benzyl penicillin have equivalent efficacy. Children treated with i.v. antibiotics were found to have significantly longer in-patient stays (3.12 versus 1.93 days; p<0.001). i.v. treatment was found to be more expensive than oral treatment ( pound1,256 versus pound769; difference pound488; 95% CI: pound233- pound750), such that treatment of community-acquired pneumonia with oral amoxicillin would result in savings of between pound473 and pound518 per child (euro545 and euro596 per child) admitted. The findings demonstrate that oral amoxicillin is a cost-effective treatment for the majority of children admitted to hospital with pneumonia.

PubMed Disclaimer

Comment in

• How to treat children's pneumonia: a complex problem.
  Don M, Korppi M. Don M, et al. Eur Respir J. 2010 Apr;35(4):932-3. doi: 10.1183/09031936.00170809. Eur Respir J. 2010. PMID: 20356993 No abstract available.

Similar articles

• Comparison of oral amoxicillin and intravenous benzyl penicillin for community acquired pneumonia in children (PIVOT trial): a multicentre pragmatic randomised controlled equivalence trial.
  Atkinson M, Lakhanpaul M, Smyth A, Vyas H, Weston V, Sithole J, Owen V, Halliday K, Sammons H, Crane J, Guntupalli N, Walton L, Ninan T, Morjaria A, Stephenson T. Atkinson M, et al. Thorax. 2007 Dec;62(12):1102-6. doi: 10.1136/thx.2006.074906. Epub 2007 Jun 13. Thorax. 2007. PMID: 17567657 Free PMC article. Clinical Trial.
• Oral amoxicillin versus injectable penicillin for severe pneumonia in children aged 3 to 59 months: a randomised multicentre equivalency study.
  Addo-Yobo E, Chisaka N, Hassan M, Hibberd P, Lozano JM, Jeena P, MacLeod WB, Maulen I, Patel A, Qazi S, Thea DM, Nguyen NT. Addo-Yobo E, et al. Lancet. 2004 Sep 25-Oct 1;364(9440):1141-8. doi: 10.1016/S0140-6736(04)17100-6. Lancet. 2004. PMID: 15451221 Clinical Trial.
• Effectiveness of early switch from intravenous to oral antibiotics in severe community acquired pneumonia: multicentre randomised trial.
  Oosterheert JJ, Bonten MJ, Schneider MM, Buskens E, Lammers JW, Hustinx WM, Kramer MH, Prins JM, Slee PH, Kaasjager K, Hoepelman AI. Oosterheert JJ, et al. BMJ. 2006 Dec 9;333(7580):1193. doi: 10.1136/bmj.38993.560984.BE. Epub 2006 Nov 7. BMJ. 2006. PMID: 17090560 Free PMC article. Clinical Trial.
• Oral Antibiotics for Community acquired Pneumonia with Chest indrawing in Children Aged Below Five Years: A Systematic Review.
  Lodha R, Randev S, Kabra SK. Lodha R, et al. Indian Pediatr. 2016 Jun 8;53(6):489-95. doi: 10.1007/s13312-016-0878-0. Indian Pediatr. 2016. PMID: 27376603 Review.
• Question 1 Are oral antibiotics as efficacious as intravenous antibiotics for the treatment of community acquired pneumonia?
  Wilder RA. Wilder RA. Arch Dis Child. 2011 Jan;96(1):103-4. doi: 10.1136/adc.2010.205047. Arch Dis Child. 2011. PMID: 21169233 Review. No abstract available.

Cited by

• Challenges of Empirical Antibiotic Therapy for Community-Acquired Pneumonia in Children.
  Rodrigues CMC. Rodrigues CMC. Curr Ther Res Clin Exp. 2017 Jan 16;84:e7-e11. doi: 10.1016/j.curtheres.2017.01.002. eCollection 2017. Curr Ther Res Clin Exp. 2017. PMID: 28761583 Free PMC article. Review.
• Childhood community-acquired pneumonia: A review of etiology- and antimicrobial treatment studies.
  Tramper-Stranders GA. Tramper-Stranders GA. Paediatr Respir Rev. 2018 Mar;26:41-48. doi: 10.1016/j.prrv.2017.06.013. Epub 2017 Jul 15. Paediatr Respir Rev. 2018. PMID: 28844414 Free PMC article. Review.
• Evaluate the Effectiveness of Outpatient Parenteral Antimicrobial Therapy (OPAT) Program in Saudi Arabia: A Retrospective Study.
  Al Shareef HJ, Al Harbi A, Alatawi Y, Aljabri A, Al-Ghanmi MA, Alzahrani MS, Algarni MA, Khobrani A, Haseeb A, AlSenani F, Elrggal ME. Al Shareef HJ, et al. Antibiotics (Basel). 2022 Mar 24;11(4):441. doi: 10.3390/antibiotics11040441. Antibiotics (Basel). 2022. PMID: 35453192 Free PMC article.
• Systematic review of economic evaluations for paediatric pulmonary diseases.
  Chitando M, Cleary S, Cunnama L. Chitando M, et al. Cost Eff Resour Alloc. 2023 Apr 30;21(1):27. doi: 10.1186/s12962-023-00423-1. Cost Eff Resour Alloc. 2023. PMID: 37121992 Free PMC article.
• Multidisciplinary Initiative to Increase Guideline-concordant Antibiotic Prescription at Discharge for Hospitalized Children with Uncomplicated Community-acquired Pneumonia.
  Yonts AB, O'Neill LB, Magyar MA, Bozzella MJ. Yonts AB, et al. Pediatr Qual Saf. 2023 Dec 12;8(6):e711. doi: 10.1097/pq9.0000000000000711. eCollection 2023 Nov-Dec. Pediatr Qual Saf. 2023. PMID: 38089829 Free PMC article.

Publication types

MeSH terms

Substances

LinkOut - more resources

• Full Text Sources

  • HighWire