While we found relatively good st and ards of reporting the study ’s question , population , interventions , comparators and conclusions , the overall reporting was poor , and evidence of unfamiliarity with international guidelines was evident ( i.e. absence of incremental analysis , of discounting long-term costs and effects ) .
Analysis or description of place-to-place variability was infrequent .
Use and acceptance of health economic evaluations ( HEEs ) has been much greater in developed than in developing nations .
Nevertheless , while developing countries lag behind in the development of HEE methods , they could benefit from the progress made in other countries and concentrate on ways in which existing methods can be used or would need to be modified to fulfill their specific needs .
HEEs , as context -specific tools , are not easily generalizable from setting to setting .
Existing studies regarding generalizability and transferability of HEEs have primarily been conducted in developed countries .
Therefore , a legitimate question for policy makers in Latin America and the Caribbean region ( LAC ) is to what extent HEEs conducted in industrialized economies and in LAC are generalizable to LAC ( trans-regional ) and to other LAC countries ( intra-regional ) , respectively .
[Prospective, randomized, comparative study of the efficacy, safety and cost of cefuroxime versus cephradine in acute pyelonephritis during pregnancy].
BACKGROUND Second generation cephalosporins ( CFPs ) are more active in the treatment of acute pyelonephritis during pregnancy but their cost is considerably higher than their predecessors . Cefuroxime , a second generation CFP with oral and parenteral presentations , might offer significant advantages and become a first choice antimicrobial in this setting . AIM To compare the efficacy , safety and cost of cefuroxime and cephradine in the treatment of acute pyelonephritis in pregnancy . PATIENTS AND METHODS Hospitalized women with 12 to 34 weeks of pregnancy , with clinical and bacteriological diagnosis of acute pyelonephritis , were r and omly assigned to receive cefuroxime ( Curocef(r ) , Glaxo Wellcome ) 750 mg t.i.d , i.v . or cephradine 1 g q.i.d . , i.v . If the isolated organism was resistant to the assigned drug the patient was excluded . Once patients were afebrile , they were switched to an oral form of the same antimicrobial . They were discharged according to the clinical status and treated for a total of 14 days . laboratory tests , including urine culture were requested during controls and at the end of follow-up at 28 days . RESULTS One hundred and one patients were r and omized : 49 to receive cephradine and 52 to receive cefuroxime . Patients in the cefuroxime group he d fewer febrile days ( mean 1.7 vs 2.2 , p < 0.05 ) , faster clinical recovery ( mean 2.7 vs 3.1 days , p < 0.05 ) , a higher rate of bacteriological cure at 28 days ( 78.8 % and 59.2 % , p < 0.05 ) and lower rate of failure ( 21.2 % vs 40.8 % p < 0.05 ) . The rate of resistance of isolated uropathogens was 14 % to cephradine and 1 % to cefuroxime . CONCLUSIONS Cefuroxime can be considered as a first choice option in the treatment of acute pyelonephritis during pregnancy due to its tolerance , microbiological activity and efficacy
While we found relatively good st and ards of reporting the study ’s question , population , interventions , comparators and conclusions , the overall reporting was poor , and evidence of unfamiliarity with international guidelines was evident ( i.e. absence of incremental analysis , of discounting long-term costs and effects ) .
Analysis or description of place-to-place variability was infrequent .
Use and acceptance of health economic evaluations ( HEEs ) has been much greater in developed than in developing nations .
Nevertheless , while developing countries lag behind in the development of HEE methods , they could benefit from the progress made in other countries and concentrate on ways in which existing methods can be used or would need to be modified to fulfill their specific needs .
HEEs , as context -specific tools , are not easily generalizable from setting to setting .
Existing studies regarding generalizability and transferability of HEEs have primarily been conducted in developed countries .
Therefore , a legitimate question for policy makers in Latin America and the Caribbean region ( LAC ) is to what extent HEEs conducted in industrialized economies and in LAC are generalizable to LAC ( trans-regional ) and to other LAC countries ( intra-regional ) , respectively .