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

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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.

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Acknowledgment

This project was funded by the NIHR Health Technology Assessment Programme (project number 05/36/01) (http://www.ncchta.org).

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Authors and Affiliations

  1. Division of Social Research in Medicines and Health, School of Pharmacy, University of Nottingham, Nottingham, NG7 2RD, UK

    Rachel A. Elliott

  2. Centre for Health Economics, University of York, Heslington, York, YO10 5DD, UK

    Helen L. A. Weatherly, Neil S. Hawkins & Mark J. Sculpher

  3. Centre for Reviews and Dissemination, University of York, Heslington, York, YO10 5DD, UK

    Gillian Cranny, Duncan Chambers, Lindsey Myers & Alison Eastwood

Authors
  1. Rachel A. Elliott
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  2. Helen L. A. Weatherly
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  3. Neil S. Hawkins
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  4. Gillian Cranny
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Correspondence to Rachel A. Elliott.

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The full version of this project is available for download at http://www.ncchta.org/project/1505.asp

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Elliott, R.A., Weatherly, H.L.A., Hawkins, N.S. et al. An economic model for the prevention of MRSA infections after surgery: non-glycopeptide or glycopeptide antibiotic prophylaxis?. Eur J Health Econ 11, 57–66 (2010). https://doi.org/10.1007/s10198-009-0175-0

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  • DOI: https://doi.org/10.1007/s10198-009-0175-0

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