Outcome and Cost of Colistin and Tigecycline for Treatment of Gram-Negative Infections

Objective: This study aimed to determine outcome and cost of colistin and tigecycline for treatment of gram-negative infections.  Methods: Data were retrospectively collected from electronic database of patients who hospitalized in Mahasarakham Hospital between January and June of 2012.  Patient characteristics, treatment outcome and cost were analyzed with appropriate statistics. Results: There were 70 patients: 40 patients receiving colistin and 30 patients receiving tigecycline. Most of them had infection with Acinebacter baumannii (100% vs. 90%). Proportion of patients with clinical improvement was higher in patients with colistin treatment than tigecycline treatment (47.5% vs. 33.3%, p=0.234). When controlling for sex, age, sepsis, ICU treatment and receiving other antibiotics, clinical improvement in patients with colistin treatment was not different from that in patients with tigecycline treatment (adjusted OR = 1.390, 95%CI 0.313 - 6.173, p=0.665). Median medication cost per patient in patients receiving colistin was lower than patients receiving tigecycline (2,640 baht vs. 37,437 baht, p<0.001). Conclusion: The findings of this study indicate that colistin and tigecycline treatment for gram-negative infections have no different outcome but treatment with colistin will reduce medication cost rather than treatment with tigecycline.