Prophylactic antibiotics for non-laboring patients with intact membranes undergoing cesarean delivery: An economic analysis
Prophylactic antibiotics for non-laboring patients with intact membranes undergoing cesarean delivery: An economic analysis
复制标题
DOI：
10.1016/j.ajog.2004.03.079
复制
发表时间：
2004-11-01
影响因子：
9.8
通讯作者：
Evantash, EG
中科院分区：
文献类型：
--
作者：
Chelmow, D;Hennesy, M;Evantash, EG
目的：我们进行了一项经济分析，预防性抗生素管理择期剖宫产deliver.Study设计：我们创建了一个决策树比较预防性抗生素（头孢唑啉1克静脉注射）的使用与不使用抗生素。我们模拟了过敏反应的可能性，包括发热和肠炎的结局。抗生素给药的结局概率和有效性来自已发表的资料。费用是从我们医院的会计系统得出的2001年估计数。敏感性分析的范围内进行的实际病人的成本和95%CI的风险和概率estimation.Results：一个简单的择期剖宫产分娩的成本为1638.57美元。发烧评估增加了125.91美元。择期手术;因尿道炎而复杂的手术费用为2327.29美元。头孢唑林管理费用为1.01美元。使用以下估计值：使用抗生素的肠炎的相对风险（RR）为0.18（95% CI 0.07-0.45），发热0.47（95% CI 0.32-0.68），未进行预防的肠炎风险为4.8%（95% CI 0.9%-43%），未进行预防的发热为14.4%（95% CI 4%-33%）。没有预防的平均病例费用为1683.72美元;预防将其降低到1653.06美元。敏感性分析在上述范围内仍然产生cost savings.Conclusion：行政预防性抗生素择期剖宫产降低成本的情况下，每例30.66美元，约2%的总成本。预防性使用抗生素可节省择期剖宫产的成本。(C)2004年爱思唯尔公司All rights reserved.
Objective: We conducted an economic analysis of prophylactic antibiotic administration for elective cesarean delivery.Study design: We created a decision tree comparing the use of prophylactic antibiotics (cefazolin 1 gm intravenous) with no antibiotic use. We modeled the potential for anaphylaxis, and included outcomes of fever and endometritis. Outcome probabilities and effectiveness of antibiotic administration were derived from published sources. Costs are 2001 estimates derived from our hospital's accounting system. Sensitivity analyses were performed over the range of actual patient costs and 95% CI of the risk and probability estimates.Results: Cost of an uncomplicated elective cesarean delivery was $1638.57. Fever evaluation added $125.91. Elective; procedure complicated by endometritis cost $2327.29. Cefazolin administration cost $1.01. The following estimates were used: relative risk (RR) of endometritis with antibiotics was 0.18 (95% CI 0.07-0.45), fever 0.47 (95% CI 0.32-0.68), risk of endometritis without prophylaxis 4.8% (95% CI 0.9%-43%), and fever without prophylaxis 14.4% (95% CI 4%-33%). Cost of an average case without prophylaxis was $1683.72; prophylaxis reduced this to $1653.06. Sensitivity analysis over the ranges above still yielded cost savings.Conclusion: Administration of prophylactic antibiotics for elective cesarean delivery reduced costs by $30.66 per case, approximately 2% of the total cost. Prophylactic antibiotic administration results in cost savings for elective cesarean delivery. (C) 2004 Elsevier Inc. All rights reserved.