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.
Keywords
azithromycin - preterm premature rupture of membranes - antibiotics - erythromycin
- latency - cost
