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Linezolid in the treatment of respiratory pneumonia: an economical alternative to vancomycin

Assisted ventilation pneumonia (PVA) remains one of the leading causes of death for critically ill patients and the most common infectious complication in the intensive care unit and the intensive care unit (ICU). According to some reports, the estimated mortality rate for VAP exceeds 30%. The cost of treating a VAP is over $ 40,000. Currently, S.aureus is increasing in the etiology of PAV. In a European multicentre observational study of 836 cases of PWA, S. aureus was the most frequently isolated pathogen. At the same time, more than 50% of S.aureus in the ICU are resistant to methicillin.

Vancomycin has so far remained the drug of choice for the treatment of ventilator-associated pneumonia caused by methicillin-resistant strains of S.aureus (MRSA). However, randomized clinical trials of a new antimicrobial drug from the oxazolidinone group - linezolid - demonstrate its great efficacy in the treatment of pneumonia caused by MSSA and MRSA. In addition, research results have shown that VAP therapy with linezolid significantly increases the likelihood of recovery and, most importantly, helps reduce mortality compared to vancomycin therapy. However, despite these advantages, linezolid is much more expensive than vancomycin, which limits its use.

To assess the financial aspects of the widespread use of linezolid for the treatment of ventilator-associated pneumonia, an analysis of the effectiveness of the additional costs of VAP therapy with linezolid compared to vancomycin was performed. A clinical decision model was chosen for the study.

The subject of the study was a hypothetical cohort of 1000 patients diagnosed with VAP. Patients received linezolid or vancomycin.

The cost-effectiveness assessment of linezolid treatment was calculated as the ratio of the additional life years of surviving patients receiving linezolid to the cost of treatment with VAP, which includes the direct cost of the drug itself, l hospitalization and treatment after discharge from hospital. The cost of an additional year of life for surviving patients receiving linezolid was approximately $ 30,000, which is less than the standard accepted by the public health unit for cost-effectiveness analysis - $ 100,000.

This study has shown that linezolid, despite all the costs associated with its use, is a cost-effective alternative to vancomycin in the treatment of ventilator-associated pneumonia.