New ATS guideline on CAP recommends erythromycin
For outpatients age 60 and under, using the antibiotic erythromycin for treating community-acquired pneumonia (CAP) reduces treatment costs compared with the use of other antibiotics ($5.43 vs. $18.51), according to a new guideline from the American Thoracic Society (ATS).
But for patients over 60, the ATS guidelines do not recommend using erythromycin alone. Additional drugs also may be needed for patients of any age with comorbidities. University of Pittsburgh researchers evaluating ATS guidelines found that antibiotics (most often amoxicillin/ clavulanate, sulfamethoxazole-trimethoprim, or cefuroxime) cost nearly 10 times more than using erythromycin ($73.50 vs. $7.50) and provide no increased effectiveness in outcomes.
These findings are part of the Pneumonia Patient Outcomes Research Team (PORT) study funded by the Agency for Health Care Policy and Research in Hyattsville, MD. It is described in the July 2 issue of the Journal of the American Medical Association. The PORT study provides the first objective data to compare the clinical effectiveness and costs of antibiotic therapy with clinical guidelines for CAP.
The study looked at 864 adults, of which 546 were under age 60 with no comorbidity and 318 were older than 60 years with at least one comorbid condition. Four million Americans are diagnosed with CAP each year; four-fifths are treated in ambulatory settings. Of the $1 billion in direct outpatient treatment costs for these patients, about $100 million is spent on some 30 antibiotics the U.S. Food and Drug Administration has approved for CAP.
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