Differential costs and outcomes among pediatric oral antibiotic formulations identified from a large prescription...

Differential performance of oral antibiotics continues to be a difficult characteristic to measure. As payers make efforts to identify selected antibiotics to place on their formularies or to reimburse, the challenge to these decision-makers is to determine which agent will work best in their population. Given the differences from one clinical trial to another, identifying performance characteristics that might impact effectiveness in clinical practice is quite challenging. This study's aim was to determine which beta-lactam and macrolide antibiotic provided the best clinical and economic outcome when used in difficult pediatric infections that previously experienced amoxicillin or cotrimoxazole failure. The findings demonstrated that cefaclor, azithromycin, and amoxicillin/clavulanate were associated with a decreased need for subsequent antibiotic therapy. Total drug treatment costs for beta-lactams and macrolides were lowest for cefaclor and azithromycin, respectively. These results are consistent with previous published literature and seem plausible given potential compliance advantages of these products as reported in studies of product tolerability and taste.