Epidemiology and pharmacoeconomic issues relating to acute respiratory tract infections and acute uncomplicated infections of the urinary tract.

Respiratory and urinary tract bacterial infections are among the most frequently encountered conditions in clinical medicine. Driven by the increasing incidence of antimicrobial resistance and treatment failures in these conditions, newer, and unfortunately more costly, alternatives are constantly being sought. As expenditures on healthcare are currently under greater levels of scrutiny than ever before, the economic aspects of drug therapy have become an important area of inquiry. Cost-effective drug therapy depends on several factors, of which initial drug cost is only one. Clearly, drug efficacy, duration of therapy and dose regimen, diagnostic strategies, route of drug administration, microbial drug resistance and patient compliance all directly impact on cost-effectiveness evaluations. However, to avoid merely shifting costs, true evaluation of cost-benefit must take indirect economic factors such as loss of patient (and parental) income, loss of productivity, opportunity costs, and patient discomfort/suffering into account. In this article, these issues are discussed and illustrated using common respiratory and urinary tract bacterial infections as a model.