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2天与5天的术后抗生素复杂尾炎:一个随机的,非劣势试验的成本分析
Elisabeth M L de Wijkerslooth1, Evert-Jan G Boerma2, Charles C van Rossem3
1Departments of Surgery, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.
将术后抗生素时间缩短到复杂尾炎的2天,与5天相比,大大降低了社会成本. 这种方法具有成本效益,可以节省成本而不会增加生产力损失.
科学领域:
- 外科手术的结果
- 卫生经济学 卫生经济学
- 传染病管理 传染病管理
背景情况:
- 限制性抗生素使用可能会减少住院时间和费用.
- 较短的抗生素持续时间对社会成本的影响未得到充分研究.
研究的目的:
- 为了比较2天和5天的术后抗生素治疗方案的社会成本.
- 为了评估复杂的尾炎手术后较短的抗生素持续时间的成本效益.
主要方法:
- 实用性,开放标签,多中心试验,包括1005名患者 (年龄≥8岁) 因复杂尾炎接受尾切除.
- 随机分配给2天或5天的静脉注射抗生素.
- 社会成本 (直接的医疗保健和生产力损失) 在手术后90天评估;计算成本效益.
主要成果:
- 与5天组相比,服用抗生素2天组的平均社会成本节约为625欧元 (95%CI: -958欧元至 -278欧元).
- 减少住院时间是节省成本的主要驱动因素;生产力损失是可比的.
- 将抗生素时间缩短到2天是具有成本效益的,每次预防感染并发症约节省了31,117欧元.
结论:
- 对复杂尾炎进行两天的术后抗生素治疗具有统计学意义,并且与5天相比更具成本效益.
- 这些发现适用于在资源充足的医疗机构内的腹腔镜尾切除术.
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