Is Procalcitonin Biomarker-Guided Antibiotic Therapy a Cost-Effective Approach to Reduce Antibiotic Resistant and Clostridium difficile Infections in Hospitalized Patients?
Autor: | Hubertus J. M. Vrijhoef, Isabelle Lepage-Nefkens, Janne C. Mewes, Lotte Maria Gertruda Steuten |
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Přispěvatelé: | RS: CAPHRI - R2 - Creating Value-Based Health Care, MUMC+: KIO Kemta (9), Health Services Research, Family Medicine and Chronic Care |
Rok vydání: | 2018 |
Předmět: |
medicine.medical_specialty
economic evaluation INTENSIVE-CARE-UNIT Population RESPIRATORY-TRACT INFECTIONS antibiotic stewardship Biochemistry Procalcitonin law.invention chronic obstructive pulmonary disease Sepsis 03 medical and health sciences 0302 clinical medicine Antibiotic resistance Randomized controlled trial law SERUM PROCALCITONIN Germany ECONOMIC BURDEN Genetics Medicine Humans 030212 general & internal medicine ALGORITHM education Molecular Biology METAANALYSIS Netherlands COPD education.field_of_study Respiratory tract infections SEPSIS business.industry ADULTS RANDOMIZED CONTROLLED-TRIAL medicine.disease Intensive care unit United Kingdom Anti-Bacterial Agents 030228 respiratory system Emergency medicine Clostridium Infections Molecular Medicine HEALTH business Biomarkers Biotechnology |
Zdroj: | OMICS-a journal of Integrative Biology, 22(9), 616-625. Mary Ann Liebert Inc. |
ISSN: | 1557-8100 1536-2310 |
Popis: | Antibiotics (AB) can reduce morbidity and mortality in the treatment of patients with sepsis and chronic obstructive pulmonary disease (COPD) exacerbations. Yet, AB overuse or misuse increases antibiotic resistance (ABR) and Clostridium difficile infections (CDI). This study projected the expected impact of a procalcitonin (PCT) biomarker testing strategy on incremental ABR cases and CDI, and costs of care in a population of patients hospitalized with suspected sepsis or a COPD exacerbation, in three European countries: the United Kingdom, Germany, and the Netherlands. Based on a systematic literature search and a decision model, we analyzed the number of ABR and CDI cases avoided and the incremental healthcare costs per patient from a societal perspective over the time horizon of a hospital stay. In the sepsis population, the PCT-guided antibiotic prescription strategy was projected to reduce the number of ABR cases with circa 6%, the number of CDI cases with 21%, and societal costs with circa Euro1300 per patient. In the COPD population, the number of ABR and CDI cases is reduced with circa 50%, and societal cost savings ranged Euro1701, Euro2473, and Euro2435 per patient in Germany, the Netherlands, and the United Kingdom, respectively. Model outcomes were most sensitive to the impact of the PCT-guided strategy on the number of intensive care unit days and general hospital ward days. Taken together, a PCT biomarker-guided antibiotic management strategy is likely to reduce the number of ABR and CDI cases and generate cost savings in a population of patients hospitalized with suspected sepsis or with a COPD exacerbation. |
Databáze: | OpenAIRE |
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