Pharmacoeconomic Analysis of Covid-19 Antimicrobial Therapy in Geriatric Inpatients

Abstract

Abstract. A new coronavirus infection, like other infections of viral etiology, is not an indication for the use of antibiotics. The cause of lung damage in COVID-19 is immune mechanisms, in which macrophages are activated and a "cytokine storm" develops, which is not affected by antibiotics. Antibacterial therapy is prescribed only if there are convincing signs of bacterial infection adherence. Therefore, a competent and reasonable approach to prescribing antibacterial drugs during a pandemic new coronavirus infection is necessary. The aim of the study was to conduct a pharmacoeconomic analysis of COVID-19 antibiotic therapy and to identify cases of irrational prescribing of antibiotics. Case histories of 334 patients treated in a reassigned hospital infectious disease unit in October 2021 with a diagnosis of Covid-19 new coronavirus infection were analyzed. The study found that antibiotic therapy was prescribed in 52.5% of patients aged 60 years or older and 38.5% of those younger than 60 years. A single antibacterial was the most frequently prescribed antibiotic 66.4% in the elderly and 78% in the young. Levofloxacin was most frequently prescribed as a starting antibiotic (32.7% of all AB prescriptions in the elderly and 54% in the young). Ceftriaxone (17.8%), Cefotaxime (15.9%), and Cefotaxime + Sulbactam (13.1%) were also commonly prescribed in those over 60 years of age. The effectiveness of antibacterial agents in the treatment of NKI was calculated using a cost-effectiveness pharmacoeconomic analysis using the criteria of therapy duration, length of hospital stay, and prescription of a second antibiotic. The best cost-effectiveness ratio was observed for prescribing ciprofloxacin (5.5), ceftriaxone (13.2), and cefotaxime (32.1) to the elderly. Irrational prescribing of antibiotics was noted in 10.8% of all antibiotic prescriptions. Of all irrational prescriptions, levofloxacin accounted for the largest number (64.7%).