Corticosteroids for the treatment of respiratory infection by Mycoplasma pneumoniae in children: A cost-utility analysis

Introduction: Increasing evidence has demonstrated the effectiveness and safety of corticosteroids in community-acquired pneumonia in children. More economic evaluations incorporating the new evidence and in the pediatric population are needed to know the efficiency of this treatment. This study aimed to evaluate the cost utility of the use of corticosteroids as adjuvant treatment for children with Mycoplasma pneumonia. Methods: A decision tree model was used to estimate the cost and quality adjusted life years (QALY) associated with cost-effectiveness as an adjunct treatment for children with Mycoplasma pneumonia with persistent signs after standard treatment with macrolide drugs for >= 1 week. Multiple sensitivity analyses were conducted. Results: The QALYs per person estimated in the model for those treatments were 0.92 with corticosteroids plus antibiotics and 0.91 with antibiotics. The total costs per person were US$965 for corticosteroids plus antibiotics and US$1271 for antibiotics. This position of absolute dominance of corticosteroids plus antibiotics over antibiotics makes it unnecessary to estimate the incremental cost-effectiveness ratio. Conclusion: Corticosteroids are cost-effective as an adjunct treatment for children with Mycoplasma pneumoniae pneumonia with persistent signs after standard treatment with macrolide drugs for >= 1 week. Our evidence should motivate the evaluation of this treatment in other countries.

Automated summary

This study evaluated the cost utility of using corticosteroids as an adjuvant treatment for children with Mycoplasma pneumonia. The results showed that using corticosteroids plus antibiotics after standard treatment with macrolide drugs for at least 1 week could improve quality adjusted life years (QALY) and reduce costs compared to using antibiotics alone.