Linezolid versus vancomycin for prosthetic joint infections: a cost analysis

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Published on: December 3, 2017

J H S You1, G C H Lee, R K H So

  • 1Centre for Pharmacoeconomics Research, School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong. joyceyou@cuhk.edu.hk

Infection
|July 25, 2007
PubMed
Abstract

Insights

Home-infusion of vancomycin is the most cost-effective treatment for prosthetic joint infections (PJIs) caused by resistant bacteria. This approach is cheaper than linezolid or inpatient vancomycin, offering significant savings for public health systems.

Area of Science:

  • Infectious Diseases
  • Pharmacoeconomics
  • Antimicrobial Therapy

Background:

  • Prosthetic joint infections (PJIs) are challenging due to methicillin-resistant gram-positive bacteria.
  • Intravenous vancomycin is the standard treatment, but linezolid offers an alternative with oral and IV options.

Purpose of the Study:

  • To compare the costs of linezolid and vancomycin therapies for PJIs.
  • To analyze costs in outpatient and inpatient settings, including home parenteral antimicrobial therapies (OHPAT).

Main Methods:

  • A decision tree model simulated clinical outcomes and healthcare resource use.
  • Cost analysis was from the perspective of a Hong Kong public healthcare provider.
  • Literature-based estimates informed clinical inputs.

Main Results:

  • Vancomycin (OHPAT) was the least costly at $14,470/patient, followed by linezolid ($17,877/patient) and vancomycin (inpatient) ($19,980/patient).
  • Monte Carlo simulations indicated vancomycin (OHPAT) was less costly than linezolid 64% of the time.
  • Clinical success rates significantly influenced cost-effectiveness.

Conclusions:

  • Home-infusion vancomycin therapy is the most economical treatment for PJIs caused by resistant gram-positive bacteria.
  • This finding is relevant for public health organizations in resource-constrained settings.
  • Cost-effectiveness supports vancomycin OHPAT for managing these complex infections.

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