An economic model for the prevention of MRSA infections after surgery: non-glycopeptide or glycopeptide antibiotic prophylaxis?

Rachel A Elliott; Helen L A Weatherly; Neil S Hawkins; Gillian Cranny; Duncan Chambers; Lindsey Myers; Alison Eastwood; Mark J Sculpher

doi:10.1007/s10198-009-0175-0

An economic model for the prevention of MRSA infections after surgery: non-glycopeptide or glycopeptide antibiotic prophylaxis?

Rachel A Elliott, Helen L A Weatherly, Neil S Hawkins, Gillian Cranny, Duncan Chambers, Lindsey Myers, Alison Eastwood, Mark J Sculpher

Division of Population Health, Health Services Research & Primary Care (L5)

University of Nottingham

Research output: Contribution to journal › Article › peer-review

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	https://doi.org/10.1007/s10198-009-0175-0
Publication status	Published - Feb 2010

Keywords

Anti-Bacterial Agents
Antibiotic Prophylaxis
Arthroplasty, Replacement, Hip
Cephalosporins
Confidence Intervals
Decision Support Techniques
Drug Therapy, Combination
Glycopeptides
Humans
Length of Stay
Methicillin-Resistant Staphylococcus aureus
Models, Economic
Odds Ratio
Quality-Adjusted Life Years
Staphylococcal Infections
Surgical Wound Infection
United Kingdom
Vancomycin
Journal Article
Research Support, Non-U.S. Gov't

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

@article{585537c346d047b1bc97dbabb4ee6aee,

title = "An economic model for the prevention of MRSA infections after surgery: non-glycopeptide or glycopeptide antibiotic prophylaxis?",

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.",

keywords = "Anti-Bacterial Agents, Antibiotic Prophylaxis, Arthroplasty, Replacement, Hip, Cephalosporins, Confidence Intervals, Decision Support Techniques, Drug Therapy, Combination, Glycopeptides, Humans, Length of Stay, Methicillin-Resistant Staphylococcus aureus, Models, Economic, Odds Ratio, Quality-Adjusted Life Years, Staphylococcal Infections, Surgical Wound Infection, United Kingdom, Vancomycin, Journal Article, Research Support, Non-U.S. Gov't",

author = "Elliott, {Rachel A} and Weatherly, {Helen L A} and Hawkins, {Neil S} and Gillian Cranny and Duncan Chambers and Lindsey Myers and Alison Eastwood and Sculpher, {Mark J}",

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doi = "10.1007/s10198-009-0175-0",

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volume = "11",

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T1 - An economic model for the prevention of MRSA infections after surgery

T2 - non-glycopeptide or glycopeptide antibiotic prophylaxis?

AU - Elliott, Rachel A

AU - Weatherly, Helen L A

AU - Hawkins, Neil S

AU - Cranny, Gillian

AU - Chambers, Duncan

AU - Myers, Lindsey

AU - Eastwood, Alison

AU - Sculpher, Mark J

PY - 2010/2

Y1 - 2010/2

N2 - 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.

AB - 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.

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KW - Cephalosporins

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KW - Decision Support Techniques

KW - Drug Therapy, Combination

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KW - Humans

KW - Length of Stay

KW - Methicillin-Resistant Staphylococcus aureus

KW - Models, Economic

KW - Odds Ratio

KW - Quality-Adjusted Life Years

KW - Staphylococcal Infections

KW - Surgical Wound Infection

KW - United Kingdom

KW - Vancomycin

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

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DO - 10.1007/s10198-009-0175-0

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JO - European Journal of Health Economics

JF - European Journal of Health Economics

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ER -

An economic model for the prevention of MRSA infections after surgery: non-glycopeptide or glycopeptide antibiotic prophylaxis?

Abstract

Keywords

UN SDGs

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