Pharmacoeconomic impact of factors affecting compliance with antibiotic regimens in the treatment of acute otitis media.

BACKGROUND The total cost of treating otitis media in the United States alone is estimated at > 3.5 billion dollars annually. Therefore treatment approaches that reduce the cost of managing otitis media can have a large impact on overall health care costs. METHODS In this study cost effectiveness factors of various antimicrobial agents, such as adverse events and overall patient acceptance, were examined. RESULTS Decreased patient acceptance and higher incidence of adverse events had a negative impact on the cost of treatment. Amoxicillin/clavulanate, cefprozil, erythromycin/sulfisoxazole and trimethoprim/sulfamethoxazole were found to be associated with decreased patient acceptance compared with cefixime. Cefixime also had the lowest number of adverse events of any of the drugs used. Amoxicillin had the lowest total cost for a single course of treatment, exclusive of costs of recurrence, which were examined in a previous study. CONCLUSION This study concluded that in cases in which several antibiotics may be clinically effective, comparative tolerability and patient acceptance data should be considered for selection of appropriate therapy. High compliance and lower morbidity can result in lower costs and better quality of life.