Related Experiment Video

Updated: Jun 20, 2026

A Robust Pneumonia Model in Immunocompetent Rodents to Evaluate Antibacterial Efficacy against S. pneumoniae, H. influenzae, K. pneumoniae, P. aeruginosa or A. baumannii
09:17

A Robust Pneumonia Model in Immunocompetent Rodents to Evaluate Antibacterial Efficacy against S. pneumoniae, H. influenzae, K. pneumoniae, P. aeruginosa or A. baumannii

Published on: January 2, 2017

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

P K Lorgelly1, M Atkinson, M Lakhanpaul

  • 1Section of Public Health and Health Policy, University of Glasgow, Glasgow, UK. paula.lorgelly@buseco.monash.edu.au

The European Respiratory Journal
|September 1, 2009
PubMed

Insights

Oral amoxicillin is a cost-effective treatment for pediatric community-acquired pneumonia. This approach minimizes healthcare costs compared to intravenous antibiotics, offering significant savings per child.

Area of Science:

  • Pediatric infectious diseases
  • Health economics
  • Pharmacoeconomics

Background:

  • Community-acquired pneumonia (CAP) imposes a significant financial burden on healthcare systems.
  • Effective and cost-efficient treatment strategies for pediatric CAP are crucial for resource optimization.

Purpose of the Study:

  • To estimate and compare the costs of treating pediatric CAP using oral amoxicillin versus intravenous benzyl penicillin.
  • To determine the cost-minimizing antibiotic treatment strategy for hospitalized children with CAP.

Main Methods:

  • A cost-minimization analysis was conducted alongside a randomized controlled non-blinded equivalence trial.
  • 232 children with pneumonia requiring hospitalization were randomized to receive either oral amoxicillin or intravenous benzyl penicillin.
  • The analysis encompassed costs to the health service, patients, and society from pre-admission to full recovery.

Main Results:

  • Both oral amoxicillin and intravenous benzyl penicillin demonstrated equivalent efficacy.
  • Children receiving intravenous antibiotics had significantly longer in-patient stays (3.12 vs. 1.93 days).
  • Intravenous treatment was substantially more expensive ( £1,256 vs. £769 per child), with savings of £473-£518 per child favoring oral amoxicillin.

Conclusions:

  • Oral amoxicillin represents a cost-effective treatment for the majority of children hospitalized with community-acquired pneumonia.
  • Switching from intravenous to oral antibiotic treatment can lead to significant cost savings for healthcare providers.
  • This study supports the use of oral amoxicillin as a primary treatment modality for pediatric CAP to reduce healthcare expenditures.

Related Concept Videos

Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence01:22

Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence

Generic intravenous (IV) drugs are considered bioequivalent to their branded counterparts due to their 100% bioavailability upon administration. However, variations in stability among different drug products can significantly influence their therapeutic performance, even if they are pharmaceutically equivalent.Cefuroxime, a prophylactic antimicrobial, is often used as a single-dose IV injection for patients undergoing coronary artery bypass grafting surgery. A 3 g dose typically provides...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Pneumonia IV: Management01:28

Pneumonia IV: Management

The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Dosage Interval and Administration Route: Determination Methods01:19

Dosage Interval and Administration Route: Determination Methods

A medication’s effectiveness largely depends on its appropriate dosage and the route of administration. Dosage ensures that a sufficient drug concentration is maintained in the bloodstream to elicit the desired therapeutic effect without causing toxicity. The route of administration affects the drug's bioavailability, rate of absorption, and onset of action, which are crucial for achieving optimal therapeutic outcomes. Drug dosage calculations are critical to tailoring therapy to individual...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...