Comparing the Cost-Effectiveness of Antibiotics for LRTI’s: A Hospital-Based Study in Pakistan

Published on: September 2025Indian Journal of Pharmacy Practice, 2026; 19(1):38-45. Original Article| doi: 10.5530/ijopp.20260373Authors and affiliation (s): Ali Hassan1,*, Muhammad Amir2, Naeem-Ur-Rehman1, Muhammad Shahid Latif1 1Faculty of Pharmacy, Gomal University, Dera Ismail Khan, Khyber Pakhtunkhwa, PAKISTAN. 2Department of Academics, La Trobe University, Melbourne, AUSTRALIA. ABSTRACT Introduction: Cost-effectiveness analysis describes measurement of relative costs of drugs with their effectiveness. Antibiotics are one of highly consumed medicine in any hospital especially rural areas have high discrepancy among antibiotic utilization. Objectives: To evaluate the cost-effectiveness of commonly used antibiotics for treating Lower Respiratory Tract Infections (LRTIs) at a secondary care hospital in Pakistan. Materials and Methods: A prospective observational study was designed to analyze cost-effectiveness among five most commonly consumed antibiotics. Study used percentage healing and symptom free days strategy to measure the effectiveness. It was conducted on 123 LRTI patients. Direct costs and effectiveness data were calculated using Data Collection Form. Five most common antibiotics: ceftriaxone, co-amoxiclav, piperacillin/tazobactam, amikacin, and moxifloxacin were selected as comparators. The comparison criteria were Cost Effectiveness Ratio (CER). Key Findings: Co-amoxiclav demonstrated the lowest CER at 13.998, indicating it as the most cost-effective option. Amikacin and Ceftriaxone followed, while Piperacillin/Tazobactam and Moxifloxacin exhibited higher CERs (49.563 and 26.569, respectively), showing less economic viability. Prescribing trends were found to be higher for ceftriaxone (n=56), followed by moxifloxacin (n=26). ICER Analysis of Piperacillin Tazobactam showed a possible increment of 232.32 PKR per unit of effectiveness. Conclusion: The study highlights Co-amoxiclav as the most cost-effective antibiotic for treating LRTIs in the evaluated hospital setting. The findings emphasize the importance of cost-effectiveness analysis in antibiotic selection to optimize healthcare resources and improve patient outcomes. Keywords: Pharmacoeconomics, Cost-Effectiveness Analysis (CEA), Antibiotics, Pharmacy Practice.