OBJECTIVES: The most pathogenic factors in hospital infections become resistant to antibiotics mostly because of the inappropriate use of them. Considering the risk of increased microbial resistance to Mupirocin, it seems necessary to have another medical treatment for controlling and treating topical infections. This study is conducted to evaluate the economic evaluation of adding Fusidic acid to the current treatment protocol. METHODS:  A decision tree model with cost-minimization analysis used from the payer’s perspective. The model was used for 1,000 hypothetical patients, half of whom assumed as burn patients and the rest as other topical infection and impetigo. The cost of Mupirocin and Fusidic acid was taken from the price list of IrFDA, and the manufacturer respectively. Considering the importance of costs due to microbial resistance and consequence side effects, the costs of systemic antibiotic treatment and hospitalization were calculated as well. One-way sensitivity analysis was performed. RESULTS: The treatment cost of 1,000 patients was estimated at 33805.5 US$ with Mupirocin arm and 11869.5 US$ with Mupirocin and Fusidic acid arm (50/50 ration for burn vs other hospital wards).Since the efficacy of the both drugs are reported to be equal, the lower cost in the arm with Fusidic acid means that this option is cost saving in comparison with Mupirocin alone (cost reduction 21.9 US$ per patient). CONCLUSIONS:

Based on this findings, adding Fusidic acid to current treatment reduced costs dramatically. Therefore, it seems that it is economically reasonable that insurance companies support the prescription and use of Fusidic acid as the second line of treatment for skin infections, which will lower the costs and the risk of antimicrobial resistance as well as improvement in the quality of life of patients.