P. Hájek

Antibiotic treatment patterns across Europe in patients with complicated skin and soft-tissue infections due to meticillin-resistant Staphylococcus aureus: a plea for implementation of early switch and early discharge criteria.

This retrospective observational medical chart review aimed to describe country-specific variations across Europe in real-world meticillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft-tissue infection (cSSTI) treatment patterns, antibiotic stewardship activity, and potential opportunities for early switch (ES) from intravenous (i.v.) to oral formulations and early discharge (ED) from hospital using standardised data collection and criteria and economic implications of these opportunities. Patients were randomly sampled from 12 countries (Austria, Czech Republic, France, Germany, Greece, Ireland, Italy, Poland, Portugal, Slovakia, Spain and the UK), aged ≥18 years, with documented MRSA cSSTI, hospitalised between 1 July 2010 and 30 June 2011, discharged alive by 31 July 2011. Of 1502 patients, 1468 received MRSA-targeted therapy. Intravenous-to-oral switch rates ranged from 2.0% to 20.2%, i.v. length of therapy from 10.1 to 18.6 days and hospital length of stay (LoS) from 15.2 to 25.0 days across Europe. Of 341 sites, 82.9% had antibiotic steering committees, 23.7% had i.v.-to-oral switch antibiotic protocols and 12.9% had ED protocols for MRSA cSSTI. ES and ED eligibility ranged from 12.0% (Slovakia) to 56.3% (Greece) and from 10% (Slovakia) to 48.2% (Portugal), respectively. Potential cost savings per ED-eligible patient ranged from €414 (Slovakia) to €2703 (France). MRSA cSSTI treatment patterns varied widely across countries, but further reductions in i.v. therapy, hospital LoS and associated costs could be realised. These data provide insight into clinical practice patterns across diverse European healthcare systems and identify potential opportunities for local clinicians and policy-makers to improve clinical care and cost-effectiveness of this therapeutic area.

Clinical and Economic Burden of Community-Acquired Pneumonia among Adults in the Czech Republic, Hungary, Poland and Slovakia

We estimate and describe the incidence rates, mortality, and cost of CAP (community-acquired pneumonia), in both inpatient and outpatient settings, in the Czech Republic (CZ), Slovakia (SK), Poland (PL), and Hungary (HU). A retrospective analysis was conducted on administrative data from the health ministry and insurance reimbursement claims with a primary diagnosis of pneumonia in 2009 to determine hospitalization rates, costs, and mortality in adults ≥50 years of age. Patient chart reviews were conducted to estimate the number of outpatient cases. Among all adults ≥50 years, the incidence of hospitalized CAP per 100,000 person years was: 456.6 (CZ), 504.6 (SK), 363.9 (PL), and 845.3 (HU). The average fatality rate for all adults ≥50 is 19.1%, and for each country; 21.7% (CZ), 20.9% (SK), 18.6% (PL), 17.8% (HU). Incidence, fatality, and likelihood of hospitalization increased with advancing age. Total healthcare costs of CAP in EUR was 12,579,543 (CZ); 9,160,774 (SK); 22,409,085 (PL); and 18,298,449 (HU); with hospitalization representing over 90% of the direct costs of treatment. The burden of CAP increases with advancing age in four CEE countries, with hospitalizations driving the costs of CAP upwards in the elderly population. Mortality rates are generally higher than reported in Western EU countries.

Early Switch/Early Discharge Opportunities for Hospitalized Patients with Methicillin-Resistant Staphylococcus Aureus Complicated Skin And Soft Tissue Infections: Proof Of Concept in the United Arab Emirates

License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php Infection and Drug Resistance 2015:8 173–179 Infection and Drug Resistance Dovepress

PIN27 COST-EFFECTIVENESS OF LINEZOLID VS. VANCOMYCIN AND TEICOPLANIN IN METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS INFECTIONS IN CZECH REPUBLIC

economic benefit between two different pneumococcal vaccines. Indirect costs were estimated for both vaccines according to the five approaches to assess the methodological influence on the total disease cost difference between PCV-7 and PHiD-CV. Baseline indirect cost estimates include the cost of productivity losses of paid workers due to disease, sequelae, and earlier death. Some of the approaches include in terms of cost: children’s future productivity losses, unpaid work loss and parents’ work loss, when looking after their sick children. RESULTS: Compared to FCM, HCM based approaches constantly generated higher estimates of indirect cost. Results of HCM ranged between a1.1bn (PHiD-CV), a1.2bn (PCV-7) and a1.9bn (both vaccines), while for FCM they ranged between a0.2bn and a0.9bna (both vaccines). Cost attributed to earlier death varied with a factor of 35; indirect cost due to earlier death as a proportion of total indirect cost varied between 16% (conservative FCM) and 79% (conservative HCM). The overall impact on total disease cost differences between the two vaccines did not alter with any approach selected (PHiD-CV always dominates PCV-7), but the amount of savings significantly differs depending on the used method. CONCLUSIONS: Although different approaches for estimating indirect cost have a huge impact on the cost difference between pneumococcal conjugate vaccines in Germany, the rating of these vaccines (PCV-7 dominated by PHiD-CV) stays unaf fected. FCM always generates lower estimates than HCM.