Do We Need Meropenem Treatment Beyond 7 Days in Febrile Neutropenic Patients: A Cost-Effectiveness Analysis

Febrile neutropenia is a critical complication in patients with hematological malignancies; immediate initiation of empirical treatment with a broad-spectrum agent is the standard of care. In this study, we aimed to evaluate the cost-effectiveness of long- and short-term antibiotic treatments.

We conducted a retrospective cohort study. We collected data on admissions between 1 January 2018 and 31 December 2022. Adult patients treated with meropenem were included and treatment duration was categorized. Short-term treatment (STT) was defined as a period of 7 days or less, and long-term treatment (LTT) was defined as longer than 7 days. To comparatively estimate costs in both groups, it was hypothesized where STT patients were assumed to receive LTT. Three scenarios were modeled to calculate potential cost reductions.

In total, 151 high-risk patients were eligible, with 93 and 58 in the STT and LTT groups, respectively. Both groups exhibited similar clinical characteristics and statistically no significant differences in outcomes. The average costs for the STT and LTT groups were statistically significantly different at USD 9294.01 and USD 13,515.27, respectively. From the regression analysis, cost reductions per patient of USD 164, 527, and 690 were estimated for the three intervention scenarios.

Notably, even though the clinical outcomes of STT were not statistically different from those of LTT, the cost of the STT group were statistically significantly lower than that of the LTT group. The early discontinuation of empirical meropenem treatment may offer financial advantages to healthcare systems.