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 .
Once daily ceftriaxone plus amikacin vs. three times daily ceftazidime plus amikacin for treatment of febrile neutropenic children with cancer. Writing Committee for the International Collaboration on Antimicrobial Treatment of Febrile Neutropenia in Children.
BACKGROUND The combination of ceftazidime plus aminoglycoside is widely used for the treatment of febrile neutropenic patients but requires multiple daily administration . Because the frequency of Pseudomonas aeruginosa is low in many centers , there is a rationale to test other antibiotic regimens that provide appropriate antibacterial coverage with the advantage of reduced dosing frequency , such as once daily ceftriaxone plus amikacin . METHODS Febrile neutropenic children with leukemia , lymphoma or solid tumors after chemotherapy were included in an open , prospect i ve , r and omized , multinational study comparing once daily ceftriaxone plus amikacin vs. 8-hourly ceftazidime and amikacin . The response to antimicrobial therapy was defined as complete response , improvement or failure . Assessment of adverse events was supplemented by specific definitions of nephrotoxicity , ototoxicity , hepatotoxicity and hypokalemia . Costs were estimated from published values of acquisition costs , delivery costs and hospitalization costs . RESULTS Efficacy was evaluable in 364 of 468 episodes in 265 children .  Response rates in ceftriaxone and amikacin vs. ceftazidime and amikacin-treated episodes were 119 of 181 ( 66 % ) vs. 121 of 183 ( 66 % ) , 7 of 181 ( 4 % ) vs. 9 of 183 ( 5 % ) and 55 of 181 ( 30 % ) vs. 53 of 181 ( 29 % ) for complete response , improvement and failure , respectively . Safety profiles were similar with both treatment regimens . The acquisition and administration costs were lower for the ceftriaxone and amikacin regimen . CONCLUSIONS A once daily regimen of ceftriaxone and amikacin is as safe and clinical ly effective as that of three times daily ceftazidime and amikacin for the treatment of febrile neutropenic children with cancer and is more cost-effective . The once daily regimen of ceftriaxone and amikacin is suitable for outpatient treatment
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 .