Cost-Effectiveness Analysis of Aztreonam–Avibactam Compared with Colistin Plus Meropenem in Treating Metallo-Beta-Lactamase-Producing Enterobacterales Infections in Spain
Introduction: Aztreonam-avibactam (ATM-AVI) is the first β-lactam/β-lactamase inhibitor antibiotic for treating serious infections caused by multidrug-resistant Gram-negative bacteria, including metallo-β-lactamases (MBL)-Enterobacterales. The objective of this analysis was to analyze the efficiency...
| Autores: | , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Fecha de publicación: | 2025 |
| País: | España |
| Institución: | Conselleria de Salut i Consum del Govern de les Illes Balears |
| Repositorio: | Docusalut |
| Idioma: | inglés |
| OAI Identifier: | oai:docusalut.com:20.500.13003/26434 |
| Acceso en línea: | https://hdl.handle.net/20.500.13003/26434 |
| Access Level: | acceso abierto |
| Palabra clave: | Anti-Bacterial Agents Azabicyclo Compounds Aztreonam Drug Combinations Gram-Negative Bacteria Gram-Negative Bacterial Infections Intraabdominal Infections Meropenem beta-Lactamases Antibacterianos Compuestos de Azabiciclo Combinación de Medicamentos Bacterias Gramnegativas Infecciones por Bacterias Gramnegativas Infecciones Intraabdominales beta-Lactamasas Antimicrobial resistance Carbapenemase producing Enterobacterales Complicated intra-abdominal infection Nosocomial pneumonia REVISIT |
| Sumario: | Introduction: Aztreonam-avibactam (ATM-AVI) is the first β-lactam/β-lactamase inhibitor antibiotic for treating serious infections caused by multidrug-resistant Gram-negative bacteria, including metallo-β-lactamases (MBL)-Enterobacterales. The objective of this analysis was to analyze the efficiency of ATM-AVI versus colistin + meropenem (COL+MER) in adult patients with complicated intra-abdominal infections (cIAI) or hospital-acquired pneumonia/ventilator-associated pneumonia (HAP/VAP) based on the REVISIT study. Methods: A model combining a decision tree and a Markov model has been adapted to the Spanish National Healthcare System perspective, considering a lifetime horizon. Patients' characteristics, clinical (probabilities of resistance, cure, mortality, recurrence, nephrotoxicity), utility, and economic inputs (direct medical costs) have been obtained from the REVISIT study and published evidence. Results: It was found that ATM-AVI is a cost-effective alternative compared to COL+MER with an incremental cost-utility ratio (ICUR) of €3116.2 per quality-adjusted life year (QALY) gained, derived of an incremental gain of 0.6 QALYs and an additional cost of €1875.9. For each indication, an ICUR of €1284.1/QALY-gained for cIAI and €4198.6/QALY-gained for HAP/VAP were obtained. Moreover, sensitivity analysis showed that ATM-AVI would be dominant in 14.5% of cases. Conclusions: ATM-AVI is a highly cost-effective antibiotic versus COL+MER in the management of patients with serious infections caused by MBL-Enterobacterales. |
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