Am J Perinatol 2019; 36(01): 105-110
DOI: 10.1055/s-0038-1667369
SMFM Fellowship Series Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Cost Analysis of Azithromycin versus Erythromycin in Pregnancies Complicated by Preterm Premature Rupture of Membranes

Matthew M. Finneran
1   Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio
,
Devin D. Smith
1   Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio
,
Catalin S. Buhimschi
1   Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio
› Author Affiliations

Funding None.
Further Information

Publication History

28 November 2017

26 June 2018

Publication Date:
13 August 2018 (online)

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Abstract

Objective To quantify the potential cost savings if azithromycin is substituted for erythromycin in women with preterm premature rupture of membranes (PPROM).

Study Design Secondary analysis of a multicentered study investigating magnesium sulfate for the prevention of cerebral palsy in premature infants. All patients with PPROM who received antibiotics for prophylaxis were included in the analysis. The number of expected doses each patient would have received was calculated for erythromycin, multidose azithromycin, and single-dose azithromycin regimens accounting for latency from PPROM to delivery. The wholesale acquisition cost was used to calculate the expected cost of each regimen.

Results There were 981 PPROM patients who received a penicillin class antibiotic and erythromycin. Patients would have received 7,528 intravenous doses and 10,194 oral doses of erythromycin at a combined cost of $357,169. In comparison, patients would have received 6,422 and 3,942 doses at a cost of $15,669 and $9,574 for the multidose and single-dose azithromycin regimens respectively, which represents a more than 95% cost reduction for either regimen compared with erythromycin.

Conclusion The use of azithromycin substituted for erythromycin in the standard antibiotic regimen of women with PPROM represents a potential for substantial cost reduction.

Note

This research was previously presented as a poster presentation at The Society for Maternal–Fetal Medicine (abstract no. 382) on January 26, 2017, in Las Vegas, NV.