对抗生素预防的成本效益分析与对急性胆囊切除术没有抗生素预防的成本效益分析
Maya Satheeskaran1, Aminah Hussan2, Ailin Anto2
1Imperial College Business School, Imperial College London, London, UK ms10618@ic.ac.uk.
BMJ open gastroenterology
|August 10, 2023
概括
对轻度至中度急性胆囊炎的抗生素预防成本效益有限,以更低的成本预防更多的术后感染并发症 (POIC). 然而,由于存在抗微生物药物耐药性问题,常规使用需要谨慎.
科学领域:
- 手术瘤学手术瘤学
- 传染性疾病 传染性疾病
- 卫生经济学 卫生经济学
背景情况:
- 腹腔镜胆囊切除术是急性胆囊炎的标准治疗方法.
- 在轻度至中度病例中,抗生素预防预防手术后感染并发症 (POICs) 的成本效益尚不清楚.
- 抗菌素耐药性增加需要有效的资源配置和明智的抗生素使用.
研究的目的:
- 进行抗生素预防与不预防轻度至中度急性胆囊炎的成本效益分析 (CEA).
- 为国家卫生服务资源分配和抗生素使用指南提供信息.
主要方法:
- 使用PEANUTS II多中心随机试验的数据进行了CEA.
- 通过在胆囊切除术后30天内避免POIC来衡量有效性.
- 费用是以英计算的.
主要成果:
- 增量成本效益比为-792.70英,表明抗生素预防成本更低,效率更高.
- 单剂量预防的POIC率为7.1%,而非预防组的POIC率为12.6%.
- 敏感性分析表明,在常规使用抗生素预防方面应谨慎.
结论:
- 抗生素预防在轻度至中度急性胆囊炎中表现出适度的成本效益.
- 这些发现支持英国在这些病例中的抗生素预防指南达成更多共识.
- 由于耐药性问题,需要进一步考虑对抗生素的系统使用.
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