Estimation of the clinical and economic consequences of non-compliance with antimicrobial treatment of XXXX skin infections.

@entity1 @entity72478 @entity115 @entity235 @entity798 @entity733 @entity6793
The goal of this study was to estimate the health and economic consequences of non-compliance with oral antimicrobial treatment in @entity235 with superficial @entity6793 , wounds or @entity733 in the US. A mathematical model (Markov model) which simulated treatment with long-term injectable @entity72478 versus oral @entity115 / @entity798 was developed and accounted for the effect of non-compliance on clinical outcomes and mean total treatment costs per @entity1 . Efficacy parameters considered in the model were derived from clinical studies. Treatment failure due to oral antimicrobial treatment non-compliance was approximated from published data at 13.6%. US cost data for 2009 were derived from public sources. When non-compliance was considered as a cause of treatment failure with oral medication, the long-term injectable antibiotic was more effective than oral comparator (162 versus 158 days without clinical signs). Mean total treatment costs were lower with @entity72478 (USD 376.74) versus @entity115 / @entity798 (USD 382.34) in @entity235 of 25 kg; and @entity72478 remained cost-saving up to a body weight of 31 kg. In large @entity235 , @entity72478 was more costly; however, total therapy costs were less than 6% greater than with @entity115 / @entity798 . Accordingly the higher drug and administration costs of the long-term injectable antibiotic were totally or substantially offset when non-compliance was considered as reason for treatment failure with oral medication. The model also allowed for the estimation of the impact of various non-compliance scenarios.
