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A cost comparison of clindamycin and aztreonam versus clindamycin and gentamicin in perforated or gangrenous appendicitis



A cost comparison of clindamycin and aztreonam versus clindamycin and gentamicin in perforated or gangrenous appendicitis



Current Therapeutic Research 42(4): 680-689



A previously reported clinical trial of clindamycin/aztreonam versus clindamycin/gentamicin as adjuvant therapy for surgically treated grangrenous or perforated appendicitis was analyzed for relative costs associated with the antibiotics. Total therapy costs were compared for the clindamycin/gentamicin patients, mean of $532.69 .+-. 130.00, and clindamycin/aztreonam patients, mean of $578.82 .+-. 96.99 and were found to be significantly different (P < 0.05). Acquisition costs were considerably greater for the combination of clindamycin/aztreonam, means of $417.44 .+-. 69.95, than for clindamycin/gentamicin, mean of $251.75 .+-. 67.22. Manufacturing costs for intravenous intermittent infusions were similar for the two groups, means of $13.25 .+-. 3.56 and and $13.21 .+-. 2.21 for clindamycin/gentamicin and clindamycin/aztreonam, respectively. Salaries for administering the antibiotics were not different between the two groups with a mean of $28.37 .+-. 7.63 for clindamycin/gentamicin and $28.29 .+-. SD $4.74 for clindamycin/aztreonam. Supplies for admixture and administration were significantly higher for clindamycin/gentamicin, mean $156.61 .+-. SD $42.12, than for clindamycin/aztreonam, $119.88 .+-. SD $20.09. The mean cost for gentamicin assay was $32.52 .+-. SD $9.00. The interpretation of the levels cost a mean of $50.18 .+-. $12.70. Thus the total costs for these activities that were unique to gentamicin were $82.70 .+-. $21.59. In summary, clindamycin/gentamin is a cheaper combination adjuvant the therapy for perforated/gangrenous appendicitis than clindamycin/aztreonam despite the costs associated with assay of gentamicin and salaries for monitoring.

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