Cost-effectiveness of prophylactic antibiotic use to prevent catheter-associated urinary tract infections

被引：4

作者：

Wang, Rui ^{[1
]}

Hacker, Michele R. ^{[1
,2
,3
]}

Lefevre, Roger ^{[1
,2
]}

机构：

[1] Beth Israel Deaconess Med Ctr, Dept Obstet, Gynecology, 330 Brookline Ave, Kirstein 3, Boston, MA 02215 USA

[2] Harvard Med Sch, Dept Obstet, Gynecology, Reprod Biol, Boston, MA 02115 USA

[3] Chan Sch Publ Hlth, Dept Epidmiol, Harvard T, Boston, MA 02115 USA

来源：

INTERNATIONAL UROGYNECOLOGY JOURNAL | 2020年 / 31卷 / 02期

关键词：

Costs and cost analysis; Cost-benefit analysis; Antibiotic prophylaxis; Urinary tract infections; Catheter-related infections;

D O I：

10.1007/s00192-019-04034-4

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Purpose We evaluate the cost-effectiveness of prophylactic antibiotic use to prevent catheter-associated urinary tract infections. Materials and methods A 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. Results The 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. Conclusions Prophylactic 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.

引用

页码：285 / 289

页数：5

共 15 条

[11] Updating Cost-Effectiveness - The Curious Resilience of the $50,000-per-QALY Threshold [J].