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Cost analysis of antibiotic prophylaxis for PEG
D Külling1, A Sonnenberg, M Fried
1Division of Gastroenterology, Department of Internal Medicine, University Hospital of Zurich, Switzerland.
Gastrointestinal Endoscopy
|January 29, 2000
Summary
Prophylactic antibiotics for percutaneous endoscopic gastrostomy (PEG) tubes are cost-effective. This strategy saves money and reduces infectious complications, making it a preferred approach.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Health Economics
Background:
- Conflicting guidelines exist on antibiotic prophylaxis for percutaneous endoscopic gastrostomy (PEG) tube placement.
- Assessing the cost-effectiveness of antibiotic prophylaxis for PEG procedures is crucial.
Purpose of the Study:
- To evaluate the cost-effectiveness of using prophylactic antibiotics during percutaneous endoscopic gastrostomy (PEG) tube insertion.
Main Methods:
- A decision tree model was developed using data from 7 prospective, placebo-controlled trials.
- Infectious complications were graded (I-III) based on treatment requirements.
- Costs were estimated using 1998 US drug pricing and Medicare data.
Main Results:
- Prophylactic antibiotics cost an average of $13.10 per procedure.
- Antibiotic prophylaxis resulted in an average cost saving of $76.72 per PEG placement.
- Sensitivity analysis confirmed prophylaxis as preferred unless Grade III complication rates were extremely low (<0.09%).
Conclusions:
- Antibiotic prophylaxis for percutaneous endoscopic gastrostomy (PEG) is a cost-effective intervention.
- The findings support the routine use of prophylactic antibiotics to improve patient outcomes and reduce healthcare costs.