• J Rello, M Nieto, J Solé-Violán, Y Wan, X Gao, C T Solem, M De Salas-Cansado, F Mesa, C Charbonneau, and J Chastre.
• CIBERES, Universitat Autónoma de Barcelona, Spain. Electronic address: jrello@crips.es.
• Med Intensiva. 2016 Nov 1; 40 (8): 474-482.

ObjectivesAdopting a unique Spanish perspective, this study aims to assess healthcare resource utilization (HCRU) and the costs of treating nosocomial pneumonia (NP) produced by methicillin-resistant Staphylococcus aureus (MRSA) in hospitalized adults using linezolid or vancomycin. An evaluation is also made of the renal failure rate and related economic outcomes between study groups.DesignAn economic post hoc evaluation of a randomized, double-blind, multicenter phase 4 study was carried out.ScopeNosocomial pneumonia due to MRSA in hospitalized adults.ParticipantsThe modified intent to treat (mITT) population comprised 224 linezolid- and 224 vancomycin-treated patients.InterventionsCosts and HCRU were evaluated between patients administered either linezolid or vancomycin, and between patients who developed renal failure and those who did not.Primary EndpointsAnalysis of HCRU outcomes and costs.ResultsTotal costs were similar between the linezolid- (€17,782±€9,615) and vancomycin-treated patients (€17,423±€9,460) (P=.69). The renal failure rate was significantly lower in the linezolid-treated patients (4% vs. 15%; P<.001). The total costs tended to be higher in patients who developed renal failure (€19,626±€10,840 vs. €17,388±€9,369; P=.14). Among the patients who developed renal failure, HCRU (days on mechanical ventilation: 13.2±10.7 vs. 7.6±3.6 days; P=.21; ICU stay: 14.4±10.5 vs. 9.9±6.6 days; P=.30; hospital stay: 19.5±9.5 vs. 16.1±11.0 days; P=.26) and cost (€17,219±€8,792 vs. €20,263±€11,350; P=.51) tended to be lower in the linezolid- vs. vancomycin-treated patients. There were no statistically significant differences in costs per patient-day between cohorts after correcting for mortality (€1000 vs. €1,010; P=.98).ConclusionsFrom a Spanish perspective, there were no statistically significant differences in total costs between the linezolid and vancomycin pneumonia cohorts. The drug cost corresponding to linezolid was partially offset by fewer renal failure adverse events.Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

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