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PP118 The Value Of New Antibiotic Treatment Strategies In Zhejiang Province, China
- Yang Wenqianzi, Zhen Xuemei, Yang Danhong, Chen Yixi, Dong Peng, Amer Al-Taie, Dong Hengjin
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- Journal:
- International Journal of Technology Assessment in Health Care / Volume 39 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 14 December 2023, p. S83
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Introduction
The rising antimicrobial resistance (AMR) and the difficulty in developing new antibiotics are causing a global public health problem. This analysis aims to better understand the clinical and economic value of new antibiotic treatment strategies, in order to inform clinical and antibiotic formulary decisions.
MethodsWe applied a published and validated dynamic disease transmission and cost-effectiveness model of AMR with a 10-year time horizon and discount rate of five percent to evaluate the clinical and economic outcomes of introducing a new antibiotic, namely, Ceftazidime/Avibactam (CAZ-AVI) for treating AMR infections in Zhejiang Province, China. Together with piperacillin-tazobactam (pip/taz) and meropenem, we explored the impact of six treatment strategies across three common infections (complicated intra-abdominal infection (cIAI), hospital-acquired/ventilator-associated pneumonia (HAP/VAP) and infections with limited treatment options (LTO)), and pathogens (Escherichia coli, Klebsiella spp., and Pseudomonas aeruginosa). These treatment strategies included (i) current treatment strategy (pip/taz and meropenem, no CAZ-AVI), (ii) CAZ-AVI at the third line, (iii) CAZ-AVI at the second line, (iv) CAZ-AVI at the first line, (v) first line diversity (i.e., equal pip/taz and CAZ-AVI at the first line; meropenem at the last line) and (vi) all-lines diversity (pip/taz, meropenem and CAZ-AVI used randomly and only once). The data with a total of 10,905 patients were collected from a tier-3 hospital from 2018 to 2021.
ResultsUnder the current treatment strategy, the hospital length of stay (LOS) and costs over ten years were estimated to be 1,588,763 days and CNY3,898,198,802 (USD559,781,348), respectively, associated with 142,999 quality-adjusted life-years (QALYs) lost, resulting in the resistance of pip/taz and meropenem being 42.0 percent and 49.9 percent respectively. In contrast, the other five treatment strategies all have shown improved outcomes, among which the “all-lines diversity” carried the greatest benefit, saving CNY1,646.04 (USD236.37) for each additional QALY gained, with the net monetary benefit being CNY24,727,102,215 (USD3,550,811,878).
ConclusionsIntroducing CAZ-AVI had positive impact on clinical and economic outcomes for treating AMR, and diversifying early the antibiotics might yield the best benefits.
Delivering 21st century Antarctic and Southern Ocean science
- M.C. Kennicutt II, Y.D. Kim, M. Rogan-Finnemore, S. Anandakrishnan, S.L. Chown, S. Colwell, D. Cowan, C. Escutia, Y. Frenot, J. Hall, D. Liggett, A.J. Mcdonald, U. Nixdorf, M.J. Siegert, J. Storey, A. Wåhlin, A. Weatherwax, G.S. Wilson, T. Wilson, R. Wooding, S. Ackley, N. Biebow, D. Blankenship, S. Bo, J. Baeseman, C.A. Cárdenas, J. Cassano, C. Danhong, J. Dañobeitia, J. Francis, J. Guldahl, G. Hashida, L. Jiménez Corbalán, A. Klepikov, J. Lee, M. Leppe, F. Lijun, J. López-Martinez, M. Memolli, Y. Motoyoshi, R. Mousalle Bueno, J. Negrete, M.A. Ojeda Cárdenes, M. Proaño Silva, S. Ramos-Garcia, H. Sala, H. Shin, X. Shijie, K. Shiraishi, T. Stockings, S. Trotter, D.G. Vaughan, J. Viera Da Unha De Menezes, V. Vlasich, Q. Weijia, J.-G. Winther, H. Miller, S. Rintoul, H. Yang
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- Journal:
- Antarctic Science / Volume 28 / Issue 6 / December 2016
- Published online by Cambridge University Press:
- 21 October 2016, pp. 407-423
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The Antarctic Roadmap Challenges (ARC) project identified critical requirements to deliver high priority Antarctic research in the 21st century. The ARC project addressed the challenges of enabling technologies, facilitating access, providing logistics and infrastructure, and capitalizing on international co-operation. Technological requirements include: i) innovative automated in situ observing systems, sensors and interoperable platforms (including power demands), ii) realistic and holistic numerical models, iii) enhanced remote sensing and sensors, iv) expanded sample collection and retrieval technologies, and v) greater cyber-infrastructure to process ‘big data’ collection, transmission and analyses while promoting data accessibility. These technologies must be widely available, performance and reliability must be improved and technologies used elsewhere must be applied to the Antarctic. Considerable Antarctic research is field-based, making access to vital geographical targets essential. Future research will require continent- and ocean-wide environmentally responsible access to coastal and interior Antarctica and the Southern Ocean. Year-round access is indispensable. The cost of future Antarctic science is great but there are opportunities for all to participate commensurate with national resources, expertise and interests. The scope of future Antarctic research will necessitate enhanced and inventive interdisciplinary and international collaborations. The full promise of Antarctic science will only be realized if nations act together.