Clarithromycin adjunct treatment leads to substantial financial savings in community-acquired pneumonia: sub-analysis of the ACCESS trial
BACKGROUND: In the ACCESS randomized controlled trial addition of oral clarithromycin 500mg two times daily for seven days to standard-of-care (SoC) antibiotics provided substantial clinical benefit in adult patients hospitalized for community-acquired pneumonia (CAP) including early clinical respon...
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Elsevier
2024-12-01
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| Series: | Journal of Global Antimicrobial Resistance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716524001917 |
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| author | Vasiliki Rapti Elisavet Tasouli Antigone Kotsaki Georgios Niotis Marios Chatzopoulos Eirini Christaki Evangelos J. Giamarellos Bourboulis Garyphalia Poulakou |
| author_facet | Vasiliki Rapti Elisavet Tasouli Antigone Kotsaki Georgios Niotis Marios Chatzopoulos Eirini Christaki Evangelos J. Giamarellos Bourboulis Garyphalia Poulakou |
| author_sort | Vasiliki Rapti |
| collection | DOAJ |
| description | BACKGROUND: In the ACCESS randomized controlled trial addition of oral clarithromycin 500mg two times daily for seven days to standard-of-care (SoC) antibiotics provided substantial clinical benefit in adult patients hospitalized for community-acquired pneumonia (CAP) including early clinical responses, decreased progression to organ dysfunction and a reduction in the incidence of secondary sepsis (Giamarellos-Bourboulis EJ, et al. Lancet Resp Med 2024; 12: 294-304). AIM: We hypothesized that the above-described clinical benefits of clarithromycin may lead to early reduction of the cost of management of CAP. METHODS: The daily cost of hospital/ICU stay, of antibiotics and all adjunctive medication (including placebo/clarithromycin) were summed for the first 8 days of the study. RESULTS: The cumulative cost for the first 8 days since start of the study drug is presented in Figure 1. By day 8, the mean total cost per patient in the SoC plus placebo group was €1332.0 compared with €1085.20 in the SoC plus clarithromycin group (p: 0.018), a saving of approximately 18% during the first week of treatment. CONCLUSIONS: The addition of clarithromycin to SoC antibiotics substantially decreased the cost of early-stage management of hospitalized patients with CAP in the ACCESS trial. The observed 16.7% improvement on live hospital discharge to day 90 with clarithromycin may be expected to contribute to additional cost savings beyond Day 8. Further analysis of the impact of clarithromycin on the overall 90-day cost will follow. |
| format | Article |
| id | doaj-art-03d557f8b5614461879893098d2cac51 |
| institution | Kabale University |
| issn | 2213-7165 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj-art-03d557f8b5614461879893098d2cac512024-12-27T04:08:14ZengElsevierJournal of Global Antimicrobial Resistance2213-71652024-12-01395Clarithromycin adjunct treatment leads to substantial financial savings in community-acquired pneumonia: sub-analysis of the ACCESS trialVasiliki Rapti0Elisavet Tasouli1Antigone Kotsaki2Georgios Niotis3Marios Chatzopoulos4Eirini Christaki5Evangelos J. Giamarellos Bourboulis6Garyphalia Poulakou7National and Kapostrian University of Athens, Athens, GreeceThriasio Elefisis General Hospital, Athens, GreeceNational and Kapostrian University of Athens, Athens, GreeceNational and Kapostrian University of Athens, Athens, GreeceG.Gennimatas Athens General Hospital, Athens, GreeceUniversity of Ioannina, Ioannina, GreeceNational and Kapostrian University of Athens, Athens, GreeceNational and Kapostrian University of Athens, Athens, GreeceBACKGROUND: In the ACCESS randomized controlled trial addition of oral clarithromycin 500mg two times daily for seven days to standard-of-care (SoC) antibiotics provided substantial clinical benefit in adult patients hospitalized for community-acquired pneumonia (CAP) including early clinical responses, decreased progression to organ dysfunction and a reduction in the incidence of secondary sepsis (Giamarellos-Bourboulis EJ, et al. Lancet Resp Med 2024; 12: 294-304). AIM: We hypothesized that the above-described clinical benefits of clarithromycin may lead to early reduction of the cost of management of CAP. METHODS: The daily cost of hospital/ICU stay, of antibiotics and all adjunctive medication (including placebo/clarithromycin) were summed for the first 8 days of the study. RESULTS: The cumulative cost for the first 8 days since start of the study drug is presented in Figure 1. By day 8, the mean total cost per patient in the SoC plus placebo group was €1332.0 compared with €1085.20 in the SoC plus clarithromycin group (p: 0.018), a saving of approximately 18% during the first week of treatment. CONCLUSIONS: The addition of clarithromycin to SoC antibiotics substantially decreased the cost of early-stage management of hospitalized patients with CAP in the ACCESS trial. The observed 16.7% improvement on live hospital discharge to day 90 with clarithromycin may be expected to contribute to additional cost savings beyond Day 8. Further analysis of the impact of clarithromycin on the overall 90-day cost will follow.http://www.sciencedirect.com/science/article/pii/S2213716524001917pneumoniaclarithromycincost |
| spellingShingle | Vasiliki Rapti Elisavet Tasouli Antigone Kotsaki Georgios Niotis Marios Chatzopoulos Eirini Christaki Evangelos J. Giamarellos Bourboulis Garyphalia Poulakou Clarithromycin adjunct treatment leads to substantial financial savings in community-acquired pneumonia: sub-analysis of the ACCESS trial Journal of Global Antimicrobial Resistance pneumonia clarithromycin cost |
| title | Clarithromycin adjunct treatment leads to substantial financial savings in community-acquired pneumonia: sub-analysis of the ACCESS trial |
| title_full | Clarithromycin adjunct treatment leads to substantial financial savings in community-acquired pneumonia: sub-analysis of the ACCESS trial |
| title_fullStr | Clarithromycin adjunct treatment leads to substantial financial savings in community-acquired pneumonia: sub-analysis of the ACCESS trial |
| title_full_unstemmed | Clarithromycin adjunct treatment leads to substantial financial savings in community-acquired pneumonia: sub-analysis of the ACCESS trial |
| title_short | Clarithromycin adjunct treatment leads to substantial financial savings in community-acquired pneumonia: sub-analysis of the ACCESS trial |
| title_sort | clarithromycin adjunct treatment leads to substantial financial savings in community acquired pneumonia sub analysis of the access trial |
| topic | pneumonia clarithromycin cost |
| url | http://www.sciencedirect.com/science/article/pii/S2213716524001917 |
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