Future pharmacoeconomic criteria for the treatment of infections.

ABSTRACT

Skin and soft tissue infections (SSTI) are a common cause of antibiotic prescriptions and loss of time from school and work. Economic pressures on the delivery of healthcare have resulted in a focus on reducing resource utilization and costs, but not always on maintaining or improving the quality of patient care. The impact of treatment failure on the overall cost of therapy is not well reported for SSTI; however, older antibiotics, which can be perceived to be less expensive, may have a higher risk of treatment failure due to the development of resistance. This can increase overall direct and indirect treatment costs, including more office or emergency department visits for additional examinations/procedures, additional prescriptions for adjuvant therapies and supplementary antibiotics and, for some infections, hospitalization or increased length of hospital stay. Selection of antibiotics with an appropriate spectrum of activity is key, while the use of antibiotics with short and/or simple dosing regimens and a good tolerability profile, such as linezolid, which maximize patient adherence to the dosing regimen, can also play a role in ensuring that adequate antibiotic therapy is received. A further consideration is the time to symptom resolution, which can have a substantial impact on the patient's quality of life as well as affecting the indirect costs of the disease (e.g. loss of productivity and lost working days for the patient or parent). Thus, careful selection of antibiotic therapy, taking into account potential health outcomes and pharmacoeconomic benefits, is important to optimize clinical and bacteriological outcomes and thereby reduce overall costs to both the healthcare system and society.