Cost effective approaches to antimicrobial use in oncology patients

In the current era of cost containment, the management of the oncology patient who presents with neutropenia and fever remains a challenge. This article will review which measures of cost are helpful in determining cost effective antibiotic use in patients with febrile neutropenia.

The majority of direct medical costs associated with treating febrile neutropenic patients are room and board costs. The most recent cost analysis reports a mean cost/day of US$1598.

Over the past two decades, infection-related mortality rates have decreased from 50% to rates as low as 10%. In contrast to the numerous studies comparing clinical outcomes of patients receiving different antimicrobial regimens for febrile neutropenia, the recent literature revealed limited studies that evaluate economic data. Typically, new antibiotic regimens show equal efficacy to the standard regimens but are often more expensive. If efficacy rates and safety are the same for an antibiotic, the cost is often used to select the product.