Economic considerations of antifungal prophylaxis in patients undergoing surgical procedures

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Health Economics

Background:

• Nosocomial fungal infections, particularly Candida bloodstream infections, are increasing in intensive care unit (ICU) patients, especially post-surgery.
• High mortality rates and diagnostic challenges associated with fungal infections prompt consideration of antifungal prophylaxis.
• Surgical patients in ICUs face elevated risks for invasive candidiasis.

Purpose of the Study:

• To evaluate the economic impact and cost-benefit ratio of antifungal prophylaxis in critically ill surgical patients.
• To synthesize existing evidence on the clinical and economic outcomes of antifungal prophylaxis in this population.
• To inform clinical decision-making regarding the use of antifungal prophylaxis in surgical ICU settings.

Main Methods:

• Systematic review and economic evaluation of published studies on antifungal prophylaxis in surgical patients.
• Analysis of costs associated with fungal infection treatment versus prophylaxis strategies.
• Consideration of factors like drug costs, adverse effects, and antifungal resistance patterns.

Main Results:

• Clinical benefits of antifungal prophylaxis in surgical ICU patients have been suggested.
• The economic impact and precise cost-benefit ratio remain incompletely defined.
• Costs of antifungal agents vary significantly, influencing overall economic evaluation.

Conclusions:

• Antifungal prophylaxis may offer economic benefits, but this requires evaluation based on local data and specific patient populations.
• Factors such as drug acquisition costs, treatment costs for invasive fungal infections, and the emergence of resistance must be considered.
• General recommendations for antifungal prophylaxis in surgical ICU patients cannot be made due to insufficient evidence and variability in local contexts.