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Introduction <p>Aztreonam–avibactam (ATM-AVI) is the first β-lactam/β-lactamase inhibitor antibiotic for treating serious infections caused by multidrug-resistant Gram-negative bacteria, including metallo-β-lactamases (MBL)-Enterobacterales. The objective of this analysis was to analyze the efficiency of ATM-AVI versus colistin&#xa0;+&#xa0;meropenem (COL+MER) in adult patients with complicated intra-abdominal infections (cIAI) or hospital-acquired pneumonia/ventilator-associated pneumonia (HAP/VAP) based on the REVISIT study.</p> Methods <p>A model combining a decision tree and a Markov model has been adapted to the Spanish National Healthcare System perspective, considering a lifetime horizon. Patients’ characteristics, clinical (probabilities of resistance, cure, mortality, recurrence, nephrotoxicity), utility, and economic inputs (direct medical costs) have been obtained from the REVISIT study and published evidence.</p> Results <p>It was found that ATM-AVI is a cost-effective alternative compared to COL+MER with an incremental cost-utility ratio (ICUR) of €3116.2 per quality-adjusted life year (QALY) gained, derived of an incremental gain of 0.6 QALYs and an additional cost of €1875.9. For each indication, an ICUR of €1284.1/QALY-gained for cIAI and €4198.6/QALY-gained for HAP/VAP were obtained. Moreover, sensitivity analysis showed that ATM-AVI would be dominant in 14.5% of cases.</p> Conclusions <p>ATM-AVI is a highly cost-effective antibiotic versus COL+MER in the management of patients with serious infections caused by MBL-Enterobacterales.</p>

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Cost-Effectiveness Analysis of Aztreonam–Avibactam Compared with Colistin Plus Meropenem in Treating Metallo-Beta-Lactamase-Producing Enterobacterales Infections in Spain

  • 期刊论文

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  • 发表日期：

    2025年11月26日

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  • Gerardo Aguilar,
  • Patricia Ruiz-Garbajosa,
  • Leonor Periañez Parraga,
  • Marta Maroto-Díaz,
  • María del Carmen de Ceano-Vivas,
  • Alba Villacampa Lordan,
  • Sara Arranz Gonzalo,
  • Alfonso de Lossada Juste,
  • Carlota Moya-Alarcón,
  • Maria Gheorghe,
  • Julián Torre-Cisneros

摘要

Introduction

Aztreonam–avibactam (ATM-AVI) is the first β-lactam/β-lactamase inhibitor antibiotic for treating serious infections caused by multidrug-resistant Gram-negative bacteria, including metallo-β-lactamases (MBL)-Enterobacterales. The objective of this analysis was to analyze the efficiency of ATM-AVI versus colistin + meropenem (COL+MER) in adult patients with complicated intra-abdominal infections (cIAI) or hospital-acquired pneumonia/ventilator-associated pneumonia (HAP/VAP) based on the REVISIT study.

Methods

A model combining a decision tree and a Markov model has been adapted to the Spanish National Healthcare System perspective, considering a lifetime horizon. Patients’ characteristics, clinical (probabilities of resistance, cure, mortality, recurrence, nephrotoxicity), utility, and economic inputs (direct medical costs) have been obtained from the REVISIT study and published evidence.

Results

It was found that ATM-AVI is a cost-effective alternative compared to COL+MER with an incremental cost-utility ratio (ICUR) of €3116.2 per quality-adjusted life year (QALY) gained, derived of an incremental gain of 0.6 QALYs and an additional cost of €1875.9. For each indication, an ICUR of €1284.1/QALY-gained for cIAI and €4198.6/QALY-gained for HAP/VAP were obtained. Moreover, sensitivity analysis showed that ATM-AVI would be dominant in 14.5% of cases.

Conclusions

ATM-AVI is a highly cost-effective antibiotic versus COL+MER in the management of patients with serious infections caused by MBL-Enterobacterales.