Abstract
Aim Surgical site infection is commonly caused by Staphylococcus aureus. The multiresistant strains (MRSA) are resistant to most antibiotic prophylaxis regimens. Our aim was to explore whether there is a threshold of MRSA prevalence at which switching to routine glycopeptide-based antibiotic prophylaxis becomes cost-effective.
Methods An indicative model was designed to explore the cost-effectiveness of vancomycin, cephalosporin or a combination, in patients undergoing primary hip arthroplasty.
Results If the MRSA infection rate is equal to or above 0.25% and the rate of other infections with cephalosporin prophylaxis is equal to or above 0.2%, use of the combination antibiotic prophylaxis is optimal.
Discussion Modelling the cost-effectiveness of interventions for MRSA prevention is complex due to uncertainty around resistance and effectiveness of glycopeptides. Conclusions The indicative model provides a framework for evaluation. More work is needed to understand the impact of antibiotic resistance over time in these currently effective antibiotics.
| Original language | English |
|---|---|
| Pages (from-to) | 57-66 |
| Number of pages | 10 |
| Journal | European Journal of Health Economics |
| Volume | 11 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Feb 2010 |
Keywords
- Economic model
- Surgical site infection
- Antimicrobial prophylaxis
- Glycopeptide
- Methicillin-resistant Staphylococcus aureus
- RESISTANT STAPHYLOCOCCUS-AUREUS
- COST-EFFECTIVENESS
- ANTIMICROBIAL RESISTANCE
- VACCINATION PROGRAMS
- SURGICAL SITE
- VANCOMYCIN
- IMPACT
- ARTHROPLASTY
- CARE
- HIP