(220) Cost-Effectiveness of IV Antibiotics Therapy for Children with Acute Gastroenteritis in a Secondary Care Hospital in South India

Publication Number: 894

Background: Acute Gastroenteritis is a common ailment affecting children. Even though it is a minor acute illness, it can contribute to various direct costs, indirect costs, and symptom-associated decreased quality of life. Even though antibiotics are not advocated as a mainstay of treatment, it is widely prescribed in Kerala due to poor recourses for differential diagnosis.

Objectives: To compare the Cost-effectiveness of IV Antibiotics therapy for children with acute gastroenteritis in a secondary care hospital in South India.

Methods: A prospective 6-month study was undertaken in the medical paediatric ward with inclusion criteria of aged 6 months–6 years; diagnosis of acute gastroenteritis; at least 3-4 reported episodes of vomiting/diarrhea 24 hours before hospital admission. Children were randomly allocated at a 1:1 ratio to either oral rehydration therapy or oral rehydration therapy plus antibiotic course. The direct medical cost was calculated from the cost of antibiotics and their consumables along with the cost for increased length of stay. Indirect costs include additional rent and loss of pay from work by the parents. The clinical outcome in the study is taken as the number of days taken to resolve all symptoms.

Results: In total, 60 children were included for randomization. Both the treatments arms showed only a slight difference in the proportion of children whose symptoms resolved within 5 days from 2.9% to 6.5% with an odds ratio of 0.9 (95% confidence interval [CI] = 0.2 to 0.6). Total mean costs in the Antibiotic group were 72.5% higher than the other group and the total incremental mean costs for an additional child free of symptom in 5 days was 650 INR (95% CI).

Conclusions: The use of Antibiotics in minor ailments without clinical evidence can lead to an additional economic burden and also contribute to antibiotic resistance.