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...

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Autores: Aguilar, Gerardo, Ruiz-Garbajosa, Patricia, Periáñez Párraga, Leonor, Maroto-Díaz, Marta, de Ceano-Vivas, María del Carmen, Villacampa Lordan, Alba, Arranz Gonzalo, Sara, de Lossada Juste, Alfonso, Moya-Alarcón, Carlota, Gheorghe, Maria, Torre-Cisneros, Julián
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
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spelling Cost-Effectiveness Analysis of Aztreonam–Avibactam Compared with Colistin Plus Meropenem in Treating Metallo-Beta-Lactamase-Producing Enterobacterales Infections in SpainAguilar, GerardoRuiz-Garbajosa, PatriciaPeriáñez Párraga, LeonorMaroto-Díaz, Martade Ceano-Vivas, María del CarmenVillacampa Lordan, AlbaArranz Gonzalo, Sarade Lossada Juste, AlfonsoMoya-Alarcón, CarlotaGheorghe, MariaTorre-Cisneros, JuliánAnti-Bacterial AgentsAzabicyclo CompoundsAztreonamDrug CombinationsGram-Negative BacteriaGram-Negative Bacterial InfectionsIntraabdominal InfectionsMeropenembeta-LactamasesAntibacterianosCompuestos de AzabicicloAztreonamCombinación de MedicamentosBacterias GramnegativasInfecciones por Bacterias GramnegativasInfecciones IntraabdominalesMeropenembeta-LactamasasAntimicrobial resistanceCarbapenemase producing EnterobacteralesComplicated intra-abdominal infectionNosocomial pneumoniaREVISITIntroduction: 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.Springer20252025-11-2620252025-11-26research articlehttp://purl.org/coar/resource_type/c_2df8fbb1info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.13003/26434reponame:Docusalutinstname:Conselleria de Salut i Consum del Govern de les Illes BalearsInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:docusalut.com:20.500.13003/264342026-06-22T12:44:07Z
dc.title.none.fl_str_mv Cost-Effectiveness Analysis of Aztreonam–Avibactam Compared with Colistin Plus Meropenem in Treating Metallo-Beta-Lactamase-Producing Enterobacterales Infections in Spain
title Cost-Effectiveness Analysis of Aztreonam–Avibactam Compared with Colistin Plus Meropenem in Treating Metallo-Beta-Lactamase-Producing Enterobacterales Infections in Spain
spellingShingle Cost-Effectiveness Analysis of Aztreonam–Avibactam Compared with Colistin Plus Meropenem in Treating Metallo-Beta-Lactamase-Producing Enterobacterales Infections in Spain
Aguilar, Gerardo
Anti-Bacterial Agents
Azabicyclo Compounds
Aztreonam
Drug Combinations
Gram-Negative Bacteria
Gram-Negative Bacterial Infections
Intraabdominal Infections
Meropenem
beta-Lactamases
Antibacterianos
Compuestos de Azabiciclo
Aztreonam
Combinación de Medicamentos
Bacterias Gramnegativas
Infecciones por Bacterias Gramnegativas
Infecciones Intraabdominales
Meropenem
beta-Lactamasas
Antimicrobial resistance
Carbapenemase producing Enterobacterales
Complicated intra-abdominal infection
Nosocomial pneumonia
REVISIT
title_short Cost-Effectiveness Analysis of Aztreonam–Avibactam Compared with Colistin Plus Meropenem in Treating Metallo-Beta-Lactamase-Producing Enterobacterales Infections in Spain
title_full Cost-Effectiveness Analysis of Aztreonam–Avibactam Compared with Colistin Plus Meropenem in Treating Metallo-Beta-Lactamase-Producing Enterobacterales Infections in Spain
title_fullStr Cost-Effectiveness Analysis of Aztreonam–Avibactam Compared with Colistin Plus Meropenem in Treating Metallo-Beta-Lactamase-Producing Enterobacterales Infections in Spain
title_full_unstemmed Cost-Effectiveness Analysis of Aztreonam–Avibactam Compared with Colistin Plus Meropenem in Treating Metallo-Beta-Lactamase-Producing Enterobacterales Infections in Spain
title_sort Cost-Effectiveness Analysis of Aztreonam–Avibactam Compared with Colistin Plus Meropenem in Treating Metallo-Beta-Lactamase-Producing Enterobacterales Infections in Spain
dc.creator.none.fl_str_mv Aguilar, Gerardo
Ruiz-Garbajosa, Patricia
Periáñez Párraga, Leonor
Maroto-Díaz, Marta
de Ceano-Vivas, María del Carmen
Villacampa Lordan, Alba
Arranz Gonzalo, Sara
de Lossada Juste, Alfonso
Moya-Alarcón, Carlota
Gheorghe, Maria
Torre-Cisneros, Julián
author Aguilar, Gerardo
author_facet Aguilar, Gerardo
Ruiz-Garbajosa, Patricia
Periáñez Párraga, Leonor
Maroto-Díaz, Marta
de Ceano-Vivas, María del Carmen
Villacampa Lordan, Alba
Arranz Gonzalo, Sara
de Lossada Juste, Alfonso
Moya-Alarcón, Carlota
Gheorghe, Maria
Torre-Cisneros, Julián
author_role author
author2 Ruiz-Garbajosa, Patricia
Periáñez Párraga, Leonor
Maroto-Díaz, Marta
de Ceano-Vivas, María del Carmen
Villacampa Lordan, Alba
Arranz Gonzalo, Sara
de Lossada Juste, Alfonso
Moya-Alarcón, Carlota
Gheorghe, Maria
Torre-Cisneros, Julián
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv Anti-Bacterial Agents
Azabicyclo Compounds
Aztreonam
Drug Combinations
Gram-Negative Bacteria
Gram-Negative Bacterial Infections
Intraabdominal Infections
Meropenem
beta-Lactamases
Antibacterianos
Compuestos de Azabiciclo
Aztreonam
Combinación de Medicamentos
Bacterias Gramnegativas
Infecciones por Bacterias Gramnegativas
Infecciones Intraabdominales
Meropenem
beta-Lactamasas
Antimicrobial resistance
Carbapenemase producing Enterobacterales
Complicated intra-abdominal infection
Nosocomial pneumonia
REVISIT
topic Anti-Bacterial Agents
Azabicyclo Compounds
Aztreonam
Drug Combinations
Gram-Negative Bacteria
Gram-Negative Bacterial Infections
Intraabdominal Infections
Meropenem
beta-Lactamases
Antibacterianos
Compuestos de Azabiciclo
Aztreonam
Combinación de Medicamentos
Bacterias Gramnegativas
Infecciones por Bacterias Gramnegativas
Infecciones Intraabdominales
Meropenem
beta-Lactamasas
Antimicrobial resistance
Carbapenemase producing Enterobacterales
Complicated intra-abdominal infection
Nosocomial pneumonia
REVISIT
description 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.
publishDate 2025
dc.date.none.fl_str_mv 2025
2025-11-26
2025
2025-11-26
dc.type.none.fl_str_mv research article
http://purl.org/coar/resource_type/c_2df8fbb1
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.13003/26434
url https://hdl.handle.net/20.500.13003/26434
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Springer
publisher.none.fl_str_mv Springer
dc.source.none.fl_str_mv reponame:Docusalut
instname:Conselleria de Salut i Consum del Govern de les Illes Balears
instname_str Conselleria de Salut i Consum del Govern de les Illes Balears
reponame_str Docusalut
collection Docusalut
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,81155

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