Cost-Effectiveness Analysis of the Use of a Prophylactic Antibiotic for Patients Undergoing Lower Limb Amputation due to Diabetes or Vascular Illness in Colombia

Mateo Ceballos, Luis Esteban Orozco, Carlos Oliver Valderrama, Diana Isabel Londoño, Luz Helena Lugo

Resultado de la investigación: Contribución a una revistaArtículo de revisiónrevisión exhaustiva

1 Cita (Scopus)

Resumen

Background: The use of a prophylactic antibiotic in an amputation surgery is a key element for
the successful recovery of the patient. We aim to determine, from the perspective of the Colombian
health system, the cost-effectiveness of administering a prophylactic antibiotic among patients
undergoing lower limb amputation due to diabetes or vascular illness in Colombia.
Methods: A decision tree was constructed to compare the use and nonuse of a prophylactic
antibiotic. The probabilities of transition were obtained from studies identified from a systematic
review of the clinical literature. The chosen health outcome was reduction in mortality due to prevention
of infection. The costs were measured by expert consensus using the standard case
methodology, and the resource valuation was carried out using national-level pricing manuals.
Deterministic sensitivity, scenarios, and probabilistic analyses were conducted.
Results: In the base case, the use of a prophylactic antibiotic compared with nonuse was a
dominant strategy. This result was consistent when considering different types of medications
and when modifying most of the variables in the model. The use of a prophylactic antibiotic
ceases to be dominant when the probability of infection is greater than 48%.
Conclusions: The administration of a prophylactic antibiotic was a dominant strategy, which is
a conclusion that holds in most cases examined; therefore, it is unlikely that the uncertainty
around the estimation of costs and benefits change the results. We recommend creating policies
oriented toward promoting the use of a prophylactic antibiotic during amputation surgery in
Colombia.
Idioma originalInglés estadounidense
Páginas (desde-hasta)327-334
Número de páginas8
PublicaciónAnnals of Vascular Surgery
Volumen40
DOI
EstadoPublicada - abr 1 2017
Publicado de forma externa

All Science Journal Classification (ASJC) codes

  • Cirugía
  • Cardiología y medicina cardiovascular

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