Cost-effectiveness of prophylactic antibiotic use to prevent catheter-associated urinary tract infections.
Cost-effectiveness of prophylactic antibiotic use to prevent catheter-associated urinary tract infections.
复制标题
预防性使用抗生素预防导管相关尿路感染的成本效益。
DOI：
10.1007/s00192-019-04034-4
复制
发表时间：
2020
影响因子：
1.8
通讯作者：
Lefevre,Roger
中科院分区：
文献类型：
--
作者：
Wang,Rui;Hacker,MicheleR;Lefevre,Roger
PurposeWe evaluate the cost-effectiveness of preventive antibiotics use to prevent catheter-associated urinary tract infections.Materials and methodsA decision tree model was used to assess the cost-effectiveness of preventive antibiotics in preventing catheter-associated urinary tract infections for patients with a short-term industrying urinary catheter.该模型解释了使用和不使用预防性抗生素的尿路感染的发生率，耐药性尿路感染的发生率，以及与诊断和治疗尿路感染和耐药性尿路感染相关的费用。费用是从医疗保健系统的角度计算的。我们进行了单向的敏感性analysis.ResultsThe基础病例分析表明，预防性使用抗生素是预防导管相关性尿路感染的成本节约。与未使用预防性抗生素相比，使用预防性抗生素可降低成本并提高质量调整生命年。敏感性分析显示，当预防性抗生素后尿路感染的发生率超过22%或未使用预防性抗生素的尿路感染发生率低于12%时，最佳策略变为不使用预防性抗生素。在合理的范围内改变预防性抗生素、尿路感染治疗或耐药尿路感染治疗的成本并没有改变最佳策略。ConclusionsPrephylactic antibiotics use to prevent catheter associated urinary tract infections is cost-effective in most conditions.这些结果对使用和不使用预防性抗生素发生导管相关尿路感染的可能性敏感。我们的研究结果仅限于这种临床实践的成本效益角度。
PurposeWe evaluate the cost-effectiveness of prophylactic antibiotic use to prevent catheter-associated urinary tract infections.Materials and methodsA decision tree model was used to assess the cost-effectiveness of prophylactic antibiotics in preventing catheter-associated urinary tract infections for patients with a short-term indwelling urinary catheter. The model accounted for incidence of urinary tract infections with and without the use of prophylactic antibiotics, incidence of antibiotic-resistant urinary tract infections, as well as costs associated with diagnosis and treatment of urinary tract infections and antibiotic-resistant urinary tract infections. Costs were calculated from the health care system’s perspective. We conducted one-way sensitivity analyses.ResultsThe base case analysis showed that the use of prophylactic antibiotics is cost-saving in preventing catheter-associated urinary tract infections. The use of prophylactic antibiotics resulted in lower costs and higher quality-adjusted life-years compared with no prophylactic antibiotics. Sensitivity analyses showed that the optimal strategy changes to no prophylactic antibiotics when the incidence of urinary tract infections after prophylactic antibiotics exceeds 22% or the incidence of developing urinary tract infections without prophylactic antibiotics is less than 12%. Varying the costs of prophylactic antibiotics, urinary tract infection treatment, or antibiotic-resistant urinary tract infection treatment within a reasonable range did not change the optimal strategy.ConclusionsProphylactic antibiotic use to prevent catheter-associated urinary tract infections is cost-effective under most conditions. These results were sensitive to the likelihood of developing catheter-associated urinary tract infections with and without prophylactic antibiotics. Our results are limited to the cost-effectiveness perspective on this clinical practice.