PHARMACOECONOMIC ANALYSIS OF RESTRICTED ANTIMICROBIALS IN THE MANAGEMENT OF SEPSIS: A PROSPECTIVE OBSERVATIONAL STUDY

Sepsis is a life-threatening condition caused by a dysregulated host response to infection and often necessitates the use of restricted antimicrobials for effective clinical management. Although these agents play an important role in treating severe infections, their high costs and inappropriate utilization may increase healthcare expenditure and contribute to antimicrobial resistance. This study aimed to evaluate the pharmacoeconomic aspects of restricted antimicrobial use in sepsis management, focusing on cost-effectiveness, cost-benefit, cost-utility, prescribing patterns, and adherence to antimicrobial stewardship protocols. A prospective observational study was conducted at Aster CMI Hospital among patients diagnosed with sepsis who received restricted antimicrobials, including meropenem, colistin, and linezolid. Data were collected using structured case report forms, documenting demographic characteristics, clinical outcomes, antimicrobial utilization, and direct medical costs. The study included 54 patients, with a reported average treatment cost of ₹1,48,247 ± SD. Pharmacoeconomic assessments incorporated cost-effectiveness analysis (CEA), cost-benefit analysis (CBA), and cost-utility analysis (CUA). Clinical success was observed in 77.78% of patients, while the mean quality-adjusted life year (QALY) gain was reported as 0.83 per patient. The estimated cost per QALY was ₹1,78,014. Adherence to antimicrobial stewardship protocols was reported to be high, supporting appropriate antimicrobial utilization and efforts to minimize unnecessary exposure. Overall, the findings highlight the importance of integrating pharmacoeconomic assessment with antimicrobial stewardship to support rational prescribing, optimize resource allocation, and promote economically sustainable sepsis care. Further studies incorporating comparative treatment groups and longer follow-up periods may help establish the broader cost-effectiveness of restricted antimicrobial therapy.