Oral versus i.v. antibiotics for community-acquired pneumonia in children: A cost-minimisation analysis

P. K. Lorgelly, M. Atkinson, M. Lakhanpaul, A. R. Smyth, H. Vyas, V. Weston, T. Stephenson

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)


Community-acquired pneumonia represents a high financial burden to healthcare providers. This manuscript seeks to estimate and compare the costs of treating children hospitalised with community-acquired pneumonia, with oral and intravenous antibiotics, thus determining which treatment is cost minimising. A cost-minimisation analysis was undertaken alongside a randomised controlled non-blinded equivalence trial. 232 children (from eight paediatric centres in England) diagnosed with pneumonia, who required admission to hospital, were randomised to receive oral amoxicillin or i.v. benzyl penicillin. The analysis considered the cost to the health service, patients and society, from pre-admission until the child was fully recovered. Oral amoxicillin and i.v. benzyl penicillin have equivalent efficacy. Children treated with i.v. antibiotics were found to have significantly longer in-patient stays (3.12 versus 1.93 days; p<0.001). i.v. treatment was found to be more expensive than oral treatment (£1,256 versus £769; difference £488; 95% CI: £233-£750), such that treatment of community-acquired pneumonia with oral amoxicillin would result in savings of between £473 and £518 per child (€545 and €596 per child) admitted. The findings demonstrate that oral amoxicillin is a cost-effective treatment for the majority of children admitted to hospital with pneumonia. 

Original languageEnglish
Pages (from-to)858-864
Number of pages7
JournalEuropean Respiratory Journal
Issue number4
Early online date31 Mar 2010
Publication statusPublished - Apr 2010
Externally publishedYes


  • Cost-minimisation analysis
  • Paediatric
  • Pneumonia
  • Treatment

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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