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Cost-effectiveness analysis of parenteral antimicrobials for acute melioidosis in Thailand

Viriya Hantrakun1, Wirongrong Chierakul2, Ploenchan Chetchotisakd3

  • 1Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand viriya@tropmedres.ac.

Transactions of the Royal Society of Tropical Medicine and Hygiene
|May 15, 2015
PubMed
Abstract

Insights

Meropenem may be a cost-effective treatment for severe melioidosis (a serious infectious disease) in Thailand, potentially reducing mortality. However, evidence for its use in non-severe cases is still needed.

Area of Science:

  • Infectious Diseases
  • Health Economics
  • Pharmacoeconomics

Background:

  • Melioidosis is a prevalent community-acquired infection in northeast Thailand with high mortality rates.
  • Current treatment guidelines recommend ceftazidime, but meropenem is increasingly used without sufficient supporting evidence.
  • Severe melioidosis cases have mortality exceeding 70%.

Purpose of the Study:

  • To evaluate the cost-effectiveness of meropenem versus ceftazidime for treating suspected acute melioidosis.
  • To compare treatment strategies for both non-severe and severe cases.

Main Methods:

  • A decision tree model was employed to analyze cost-effectiveness.
  • The model assessed treatment outcomes for suspected acute melioidosis.

Main Results:

  • Meropenem is likely cost-effective for severe melioidosis if it reduces mortality by at least 9% and culture-confirmed cases exceed 20%.
  • Cost-effectiveness for non-severe melioidosis treatment with meropenem remains undetermined.

Conclusions:

  • Meropenem is likely a cost-effective option for treating severe suspected melioidosis in this region.
  • Further evidence is required to support the use of meropenem in non-severe suspected melioidosis cases.
Keywords:
AntimicrobialsCeftazidimeCost-effective treatmentMeliodosisMeropenemNortheast Thailand

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