Effectiveness, safety, and cost-effectiveness of norvancomycin in the management of acute hematogenous osteomyelitis in pediatric patients: A retrospective case study

Medicine (Baltimore). 2024 Nov 8;103(45):e40335. doi: 10.1097/MD.0000000000040335.

Abstract

This study was designed to investigate the effectiveness, safety, and cost-effectiveness of norvancomycin in the management of acute hematogenous osteomyelitis in pediatric patients. We conducted a retrospective study on cases of osteomyelitis in pediatric patients treated with norvancomycin or vancomycin at Hebei Children's Hospital from January 2015 to February 2023. The patients were categorized into the norvancomycin group and the vancomycin group. Clinical data regarding efficacy, safety, and cost-effectiveness before and after drug treatment were collected for comparative analysis. Each group contained 104 children. After 14 days of treatment, there were no statistically significant differences in the incidence of adverse events and efficacy indexes between the 2 groups. However, the total hospitalization cost of the norvancomycin group (¥28765.35 ± ¥11835.98) was significantly lower than that of the vancomycin group (¥43776.06 ± ¥33365.30) (P = .000). Additionally, compared to the vancomycin group, both the clinical efficacy cost ratio (290.44 vs 437.76) and bacteriological clearance cost ratio (356.14 vs 576.30) were lower in the norvancomycin group. Norvancomycin demonstrates comparable efficacy to the first-line drug vancomycin in treating acute hematogenous osteomyelitis in pediatric patients. Moreover, norvancomycin can significantly mitigate treatment expenses and exhibit favorable cost-effectiveness.

MeSH terms

  • Acute Disease
  • Adolescent
  • Anti-Bacterial Agents* / economics
  • Anti-Bacterial Agents* / therapeutic use
  • Child
  • Child, Preschool
  • China
  • Cost-Benefit Analysis*
  • Female
  • Humans
  • Infant
  • Male
  • Osteomyelitis* / drug therapy
  • Osteomyelitis* / economics
  • Retrospective Studies
  • Treatment Outcome
  • Vancomycin* / analogs & derivatives
  • Vancomycin* / economics
  • Vancomycin* / therapeutic use

Substances

  • Vancomycin
  • Anti-Bacterial Agents
  • norvancomycin