The cost-effectiveness of procalcitonin for guiding antibiotic prescribing in individuals hospitalized with COVID-19: part of the PEACH study.
J Antimicrob Chemother
; 79(8): 1831-1842, 2024 Aug 01.
Article
en En
| MEDLINE
| ID: mdl-38842487
ABSTRACT
BACKGROUND:
Many hospitals introduced procalcitonin (PCT) testing to help diagnose bacterial coinfection in individuals with COVID-19, and guide antibiotic decision-making during the COVID-19 pandemic in the UK.OBJECTIVES:
Evaluating cost-effectiveness of using PCT to guide antibiotic decisions in individuals hospitalized with COVID-19, as part of a wider research programme.METHODS:
Retrospective individual-level data on patients hospitalized with COVID-19 were collected from 11 NHS acute hospital Trusts and Health Boards from England and Wales, which varied in their use of baseline PCT testing during the first COVID-19 pandemic wave. A matched analysis (part of a wider analysis reported elsewhere) created groups of patients whose PCT was/was not tested at baseline. A model was created with combined decision tree/Markov phases, parameterized with quality-of-life/unit cost estimates from the literature, and used to estimate costs and quality-adjusted life years (QALYs). Cost-effectiveness was judged at a £20â000/QALY threshold. Uncertainty was characterized using bootstrapping.RESULTS:
People who had baseline PCT testing had shorter general ward/ICU stays and spent less time on antibiotics, though with overlap between the groups' 95% CIs. Those with baseline PCT testing accrued more QALYs (8.76 versus 8.62) and lower costs (£9830 versus £10â700). The point estimate was baseline PCT testing being dominant over no baseline testing, though with uncertainty the probability of cost-effectiveness was 0.579 with a 1 year horizon and 0.872 with a lifetime horizon.CONCLUSIONS:
Using PCT to guide antibiotic therapy in individuals hospitalized with COVID-19 is more likely to be cost-effective than not, albeit with uncertainty.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Análisis Costo-Beneficio
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Polipéptido alfa Relacionado con Calcitonina
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COVID-19
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Antibacterianos
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
J Antimicrob Chemother
/
J. antimicrob. chemother
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Journal of antimicrobial chemotherapy
Año:
2024
Tipo del documento:
Article