Descriptive and Cost-effectiveness Analyses of Typhoid Fever Management in Two University Hospitals in Southeast AsiaTri Wihartini, Mohamed Izham Mohamed Ibrahim and Syed Azhar Syed Sulaiman
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Introduction: The traditional therapy for typhoid though still being used, in most developing countries are gradually being replaced with new and shorter courses of treatment. Objectives: To study the pattern of management of typhoid between Ciptomangunkusumo Hospital, Indonesia (RSCM) and Universiti Sains Malaysia Hospital, Malaysia (HUSM) and to analyze the cost and effectiveness of chloramphenicol vs. ciprofloxacin used at RSCM. Methods: A retrospective study was conducted in two hospitals by using typhoid patient’s medical records as samples. Cost-effectiveness analysis (CEA) was performed to analyze the direct cost and effectiveness of regimens used for treating patients. Dependent variables observed were cure rate (effectiveness), length of stay (LOS) in hospital, fever clearance time (FCT) and improvement of the signs and symptoms. Results: A total number of 64 and 56 medical records of uncomplicated typhoid fever among adult patients were collected from RSCM and HUSM, respectively. The results indicated that cost-effectiveness (CE) ratio between the two antibiotics when taking into consideration of both the FCT and cure rate favored chloramphenicol. The first average CE ratio in terms of FCT was RM95.72/day for chloramphenicol vs. RM108.55/day for ciprofloxacin, while the second average CE ratio was RM358 per cured patient for chloramphenicol vs. RM526.6 per cured patient for ciprofloxacin. Conclusions: Cost-effectiveness analysis showed that chloramphenicol is more cost-effective if compared to ciprofloxacin in treating typhoid fever and approximately RM22.83 per patient can be saved if patient is treated with chloramphenicol.
Keyword:
Cost-effectiveness ,Typhoid,RSCM,HUSM,chloramphenicol ,ciprofloxacin
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