What is the Cost of Diagnosis and Management
A substantial proportion of DR-TB costs were attributed to XDR-TB. The national DR-TB guidelines recommend that the majority of cases be treated as outpatients and only severely ill MDR-TB patients should be admitted for hospitalization (10 of cases). This was due to the high cost of managing DR-TB. An inpatient day at BCH costs.07 whereas an outpatient visit costs.16. World Health Organization (2011) Tuberculosis Country Profiles: South Africa (2011) Available:.Accessed 2012 Jul. Am J Respir Crit Care Med 184: 132140. While decentralized MDR-TB treatment is now the current policy in South Africa, it is not fully implemented across all provinces and our assumption of predominant outpatient care for these patients may underestimate the cost of MDR-TB. Inpatient and outpatient costs were calculated using a WHO standardised tool for economic analyses. Dheda K, Shean K, Zumla A, Badri M, Streicher EM,. HIV ARV drug costs have been excluded from the analysis as the incremental costs would be zero for MDR-TB, XDR-TB and DS-TB if HIV ARV therapy was assessed for an equivalent period. Approximately 5 to 10 of all MDR-TB cases are extensively-drug-resistant TB (XDR-TB defined as MDR-TB plus additional culture-confirmed resistance to a fluoroquinolone and an injectable agent (2nd line aminoglycoside or capreomycin). Thus, targeting this component of DR-TB could potentially reduce costs substantially. These savings would primarily be made through reduced hospitalization costs, which contribute to over half of all XDR-TB costs.
Effects of the pharmaceutical technologic aspects
Variation in the proportion of non converters (treatment failures) also caused noticeable changes in overall DR-TB costs, mainly due to the increased length of hospitalization required in these individuals. (2011) Available: http treasury. Drugs such as clarithromycin and augmentin contributed to these costs (4 of total XDR-TB drug costs) despite being of uncertain value in the effective treatment of cases. General information: If you have any questions about Augmentin, please talk with your doctor, pharmacist, or other health care provider. This cost was twenty-six times greater than DS-TB with 49 of these costs being attributable to anti-MDR-TB drugs ( Figure 1 ).
Hospital outbreak of multi-resistant
Hospitalisation costs comprise the majority of the DR-TB national costs (58) under this assumption. Indeed, despite the small number of total cases of XDR-TB (0.2 of total notified cases in 2010 the cost was disproportionately expensive (26,392.01 per case and representing 9 of the estimated total national TB costs). Wrote the paper: AP MD. Primary care clinic visit costs were calculated, in a similar manner to inpatient and outpatient costs, using data from two TB clinics located in the Cape Town Metro region, Langa Clinic and Chapel Street Clinic. Diabetes patients - Augmentin may cause the results of some tests for urine glucose to be wrong. All costs were expressed in 2011 US at an exchange rate of 1USD ZAR7.05. All other GPs can access mims in print by subscription. Check with your health care provider before you start, stop, or change the dose of any medicine. Brand: POM, code: 0313932, weight: 110g (includes packaging). Intermedia use steroid hormones as growth factors, so their numbers are higher in pregnant women. Click the target next to the incorrect Subject Area and let us know. However, in the absence of regulatory guidelines regarding the monitoring frequency of XDR-TB outpatients and due to the poorer XDR-TB outcomes, we assume these patients will be monitored more closely than in MDR-TB. However, implementation of such a strategy remains contentious as these patients need to be closely monitored, (particularly for capreomycin-related electrolyte abnormalities) and educated in proper infection control practices. We estimate that approximately 50 of XDR-TB cases will be suitable for ambulatory care (based on clinical experience and estimated by the proportion of XDR-TB patients who weigh 50 kg at diagnosis, which has shown to be associated with worse treatment outcomes 6 ).