{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T16:42:04Z","timestamp":1761064924327,"version":"build-2065373602"},"reference-count":45,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,1,6]],"date-time":"2012-01-06T00:00:00Z","timestamp":1325808000000},"content-version":"vor","delay-in-days":250,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:p><jats:bold>Study Objective.<\/jats:bold> To compare meropenem with ciprofloxacin for treatment of gram\u2010negative bacilli sepsis in penicillin\u2010allergic patients in the intensive care unit (ICU) to determine if increased anaphylaxis risk with meropenem precluded its use when weighed against risks of inactive therapy with ciprofloxacin.<\/jats:p><jats:p><jats:bold>Design.<\/jats:bold> A decision model constructed from probability distributions from the literature and data from a local ICU antibiogram. A probabilistic sensitivity analysis was performed to evaluate uncertainty in variable estimates by using one\u2010way analyses, two\u2010way analyses, and Monte Carlo simulation.<\/jats:p><jats:p><jats:bold>Measurements and Main Results.<\/jats:bold> Microbiologic activity of treatment, anaphylaxis according to treatment regimen, curability of infection according to patient morbidity status, risk of superinfection, and recovery from gram\u2010negative bacilli sepsis were the variables modeled. Effectiveness was defined by long\u2010term survival and was modeled as life\u2010years (LYs) and quality\u2010adjusted life\u2010years (QALYs) gained according to treatment group. Base case results were the incremental differences between the average effectiveness of each strategy calculated from the Monte Carlo simulation. Mean LYs and QALYs gained with meropenem were 9.9 (95% confidence interval [CI] 8.9\u201310.8) and 5.9 (95% CI 4.8\u20136.7), respectively. Mean LYs and QALYs gained with ciprofloxacin were 8.9 (95% CI 8.1\u20139.6) and 5.3 (95% CI 4.4\u20136.3), respectively. The incremental difference in effective\u2010ness\u2014or average benefit expected by selecting meropenem over ciprofloxacin\u2014was 1.0 LY (95% CI 0.3\u20131.7 LYs) and 0.6 QALY (95% CI 0.2\u20131.1 QALYs) favoring meropenem.<\/jats:p><jats:p><jats:bold>Conclusion.<\/jats:bold> Use of empiric meropenem over ciprofloxacin may be justified in patients in the ICU who are allergic to penicillin.<\/jats:p>","DOI":"10.1592\/phco.31.5.469","type":"journal-article","created":{"date-parts":[[2011,4,25]],"date-time":"2011-04-25T13:56:27Z","timestamp":1303739787000},"page":"469-479","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Life\u2010Years Gained with Meropenem over Ciprofloxacin in Penicillin\u2010Allergic Patients with Gram\u2010Negative Bacilli Sepsis: Results of aP robabilistic Model"],"prefix":"10.1002","volume":"31","author":[{"given":"Marc H.","family":"Scheetz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maureen K.","family":"Bolon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John S.","family":"Esterly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pavani","family":"Reddy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Postelnick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd A.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,1,6]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra993637"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2005.01.010"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/149.1.16"},{"key":"e_1_2_1_5_2","unstructured":"U.S. Food and Drug Administration.Current drug shortages. 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