The Cost-effectiveness of Antimicrobial Lock Solutions for the Prevention of Central Line-Associated Bloodstream Infections
| Autor: | Elina Eleftheria Pliakos, Panayiotis D. Ziakas, Eleftherios Mylonakis, Nikolaos Andreatos |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Microbiology (medical) medicine.medical_specialty Catheterization Central Venous Record locking Cost effectiveness medicine.medical_treatment Cost-Benefit Analysis 030106 microbiology 03 medical and health sciences 0302 clinical medicine Bloodstream infection Sepsis Medicine Humans 030212 general & internal medicine Intensive care medicine Central line Cost–benefit analysis business.industry Incidence Antimicrobial Disinfection Infectious Diseases Parenteral nutrition Catheter-Related Infections Hemodialysis business Disinfectants |
| Zdroj: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 68(3) |
| ISSN: | 1537-6591 |
| Popis: | Background Antimicrobial lock solutions are a low-cost strategy that can reduce the incidence of central line-associated bloodstream infection (CLABSI). The aim of this study was to evaluate the cost-effectiveness of antimicrobial locks for the prevention of CLABSI. Methods We constructed a decision-analytic model comparing antimicrobial lock solutions to heparin locks for the prevention of CLABSI in 3 settings: hemodialysis, cancer treatment, and home parenteral nutrition. Cost-effectiveness was determined by calculating CLABSIs prevented and incremental cost-effectiveness ratios. Uncertainty was addressed by plotting cost-effectiveness planes and acceptability curves for various willingness-to-pay thresholds. Results In probabilistic analysis, at a willingness to pay of $50000, antimicrobial lock solutions had a 96.24% chance of being cost-effective, compared with heparin locks in the hemodialysis setting, an 88.00% chance in the cancer treatment setting, and a 92.73% chance in the home parenteral nutrition setting. In base-case analysis, antimicrobial lock solutions resulted in savings of $68721.03 for the hemodialysis setting, $85061.41 for the cancer setting, and $78513.83 for the home parenteral nutrition setting per CLABSI episode prevented. Conclusions In 3 distinct and clinically important settings (hemodialysis, cancer treatment, and home parenteral nutrition), antimicrobial lock solutions are an effective strategy for the prevention of CLABSI, and their use can result in significant healthcare savings. |
| Databáze: | OpenAIRE |
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