Antibacterial therapy of the urinary tract infections: Pharmacoeconomic aspect

Abstract

Urinary tract infections are inflammations processes on lower or upper parts of urinary tract. Therapy of urinary tract infections differs for complicated and non-complicated infections and site of infection. The aim of this paper is pharmacoeconomic analysis of different strategies in management of urinary tract infections from the perspective of Republic Fond for Health Insurance. The decision tree was constructed to evaluate costs and effectiveness of different strategies used for treatment of non-pregnant, adult women. As a positive outcome of the treatment number of cases where simptoms disapered is used. The results implied that the least costly strategy available is empiric treatment. More expensive but with greater outcomes was the strategy involving laboratory test together with empiric treatment. Although the empiric treatment proved to be cost-effective and in accordance with current recommendations and guidelines for therapy, recognition of the impact of this strategy upon antibiotic resistance may lead to conclusion that the dipstick strategy is superior strategy.

Infekcije urinarnog trakta zahvataju donje i gornje delove urinarnog trakta. Terapija infekcija se razlikuje u zavisnosti da li su u pitanju komplikovane ili nekomplikovane infekcije kao i od mesta infekcije. Cilj ovog rada je farmakoekonomska analiza isplativosti primene različitih strategija u lečenju infekcija urinarnog trakta iz perspektive Republičkog fonda za zdravstveno osiguranje. Zarad procene troškova i efikasnosti primene različitih strategija u lečenju infekcija urinarnog trakta u odraslih žena koje nisu trudne konstruisano je drvo odlučivanja. Kao ishod lečenja posmatran je broj slučajeva u kojima je došlo do prestanka simptoma. Rezultati istraživanja su pokazali da je najisplativija strategija empirijska primena antibiotika. Nešto skuplja i efikasnija strategija je primena laboratorijskih testova uz empirijsku primenu antibiotika. Iako je empirijska primena antibiotika troškovno isplativa i u skladu sa važećim preporukama i protokolima lečenja infekcije urinarnog trakta, ukoliko se razmotri i antibiotska rezistencija kao rastući zdravstveni problem, strategija primene dipstik testa može biti superiorna.