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

Ceballos, Mateo; Orozco, Luis E.; Valderrama, Carlos; Londoño, Diana Isabel; Lugo, Luz Helena

doi:10.1016/j.avsg.2016.07.090

Cited by 3 publications

(6 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The general characteristics of the included studies are presented in Table 1 . For the further characteristics of the 20 included studies, the most studies came from North-America (Wilson et al, 2008 ; Courville et al, 2012 ; Emohare et al, 2014 ; Matsui et al, 2014 ; Singh et al, 2014 ; Theologis et al, 2014 ; Graves et al, 2016 ; Lewis et al, 2016 ), followed by Asia (Kosus et al, 2010 ; Patil et al, 2011 ; Gulluoglu et al, 2013 ; Ozdemir et al, 2016 ), Europe (Chaudhuri et al, 2006 ; Dhadwal et al, 2007 ; Elliott et al, 2010 ; Joshi et al, 2016 ), Africa (Alekwe et al, 2008 ; El-Mahallawy et al, 2013 ), Australia (Merollini et al, 2013 ), and South America (Ceballos et al, 2017 ). The reviewed articles concerned 14 trial-based studies (Chaudhuri et al, 2006 ; Dhadwal et al, 2007 ; Alekwe et al, 2008 ; Wilson et al, 2008 ; Kosus et al, 2010 ; Patil et al, 2011 ; El-Mahallawy et al, 2013 ; Gulluoglu et al, 2013 ; Emohare et al, 2014 ; Matsui et al, 2014 ; Theologis et al, 2014 ; Joshi et al, 2016 ; Lewis et al, 2016 ; Ozdemir et al, 2016 ) and 6 model-based studies (Elliott et al, 2010 ; Courville et al, 2012 ; Merollini et al, 2013 ; Singh et al, 2014 ; Graves et al, 2016 ; Ceballos et al, 2017 ).…”

Section: Resultsmentioning

confidence: 99%

“…Various studies modeled economic and clinical impacts from the societal and healthcare perspectives of patients undergoing total hip arthroplasty (THA), total knee arthroplasty (TKA), and lower limb amputation (Elliott et al, 2010 ; Courville et al, 2012 ; Merollini et al, 2013 ; Graves et al, 2016 ; Ceballos et al, 2017 ). Economic analysis on the implementation of the use of nasal mupirocin to prevent deep SSI of Staphylococcus aureus in THA and TKA showed that mupirocin was more cost-effective compared to non-preoperatively administered mupirocin with incremental cost-effectiveness ratios (ICERs) at US$380.09/QALY and US$517.16/QALY for THA and TKA respectively (Courville et al, 2012 ).…”

Section: Resultsmentioning

confidence: 99%

“…Clinically and economically, these percentages were considered to reflect a significant impact with cost savings of US$2,762 per operative procedure at day 90 post-surgery (Theologis et al, 2014 ). Furthermore, two studies addressed that prophylactic intervention was dominant over no prophylactic antibiotics on SSI rates and cost reductions in total hip arthroplasty and lower limb amputation (Merollini et al, 2013 ; Ceballos et al, 2017 ).…”

Section: Resultsmentioning

confidence: 99%

“…The quality assessment scores of studies regarding general surgery ranged from 10 to 12 (Chaudhuri et al, 2006 ; Wilson et al, 2008 ; Matsui et al, 2014 ; Singh et al, 2014 ; Ozdemir et al, 2016 ). Among studies on orthopedic surgery and neurosurgery, the quality ranged between 12 and 18.5 (Elliott et al, 2010 ; Courville et al, 2012 ; Merollini et al, 2013 ; Emohare et al, 2014 ; Theologis et al, 2014 ; Graves et al, 2016 ; Lewis et al, 2016 ; Ceballos et al, 2017 ). Two cardiothoracic studies scored 8 and 11.5 points for CHEC items (Dhadwal et al, 2007 ; Joshi et al, 2016 ).…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Prevention of Surgical Site Infections: A Systematic Review of Cost Analyses in the Use of Prophylactic Antibiotics

et al. 2018

View full text Add to dashboard Cite

Introduction: The preoperative phase is an important period in which to prevent surgical site infections (SSIs). Prophylactic antibiotic use helps to reduce SSI rates, leading to reductions in hospitalization time and cost. In clinical practice, besides effectiveness and safety, the selection of prophylactic antibiotic agents should also consider the evidence with regard to costs and microbiological results. This review assessed the current research related to the use of antibiotics for SSI prophylaxis from an economic perspective and the underlying epidemiology of microbiological findings.Methods: A literature search was carried out through PubMed and Embase databases from 1 January 2006 to 31 August 2017. The relevant studies which reported the use of prophylactic antibiotics, SSI rates, and costs were included for analysis. The causing pathogens for SSIs were categorized by sites of the surgery. The quality of reporting on each included study was assessed with the “Consensus on Health Economic Criteria” (CHEC).Results: We identified 20 eligible full-text studies that met our inclusion criteria, which were subsequently assessed, studies had in a reporting quality scored on the CHEC list averaging 13.03 (8–18.5). Of the included studies, 14 were trial-based studies, and the others were model-based studies. The SSI rates ranged from 0 to 71.1% with costs amounting to US$480-22,130. Twenty-four bacteria were identified as causative agents of SSIs. Gram negatives were the dominant causes of SSIs especially in general surgery, neurosurgery, cardiothoracic surgery, and obstetric cesarean sections.Conclusions: Varying results were reported in the studies reviewed. Yet, information from both trial-based and model-based costing studies could be considered in the clinical implementation of proper and efficient use of prophylactic antibiotics to prevent SSIs and antimicrobial resistance.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Prevention of Surgical Site Infections: A Systematic Review of Cost Analyses in the Use of Prophylactic Antibiotics

et al. 2018

View full text Add to dashboard Cite

show abstract

“…In the fifth economic evaluation on the cost-effectiveness of prophylactic antibiotics, it was found that this is a dominant strategy and it is unlikely that the uncertainty surrounding the costs and benefits changes the results, the use of this intervention is recommended in Colombia ( 25 ).…”

Section: Resultsmentioning

confidence: 99%

Development of a Clinical Practice Guideline for Lower Limb Amputees. A Knowledge Translation Process in a Middle Income Country

Borrero

Patiño-Lugo

Plata-Contreras

et al. 2022

Front. Rehabilit. Sci.

View full text Add to dashboard Cite

Background and AimKnowledge translation processes are necessary for improving patients' and communities' health outcomes. The aim of this study was to systematically develop evidence-based recommendations for people over 16 years of age who are in risk for or have suffered a lower limb amputation for medical reasons (vascular, diabetes mellitus) or trauma (civilian or military trauma) in order to improve function, quality of life, decrease complications and morbidity.MethodsFollowing the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach we developed a Clinical Practice Guideline (CPG) for lower limb amputees with funding from the Ministry of Health in Colombia and participation of a multidisciplinary group. We included patients' preferences. Based on the scope, purposes and objectives the questions were elaborated with the PECOT strategy. The evidence search was performed for each question in the main databases: Cochrane Library, Embase and PubMed, without time limit or language restriction. Teams were formed with thematic experts and clinical epidemiologists to review the clinical studies, describe the evidence, and evaluate the quality of the body of evidence with the GRADE methodology. The recommendations were made according to the judgments proposed by the GRADE working group. We conducted a stakeholder's dialogue as a mechanism for the external validation of the guideline implementation.ResultsThe CPG included 43 recommendations related to the diagnosis, surgical treatment, rehabilitation, prescription and adaptation of the prosthesis. They were strong in favor 37.2, weak in favor 53.5, strong against 2.3, Weak against 7.0%. Quality of evidence was high in 0, moderate in 11.6, low in 58.1, and very low 30.2%.DiscussionIn 93% of the recommendations, the quality of the evidence was between low and very low. This is why it was so important to validate and discuss each recommendation with an expanded multidisciplinary group. The research group identified 25 interventions and five milestones to be prioritized in the implementation and in the stakeholder's dialogue participants identified opportunities and barriers for implementation of recommendations.ConclusionIt is necessary to develop a national policy for implementation strategies of CPG recommendations that promotes the necessary arrangements for the provision of services for diagnosis, treatment, and rehabilitation of individuals with amputations.

show abstract

Risk factors for reamputation in patients with diabetic foot: A case-control study

Correa

Vargas-Hernandez

García

et al. 2023

Foot and Ankle Surgery

View full text Add to dashboard Cite

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

Cited by 3 publications

References 25 publications

Prevention of Surgical Site Infections: A Systematic Review of Cost Analyses in the Use of Prophylactic Antibiotics

Prevention of Surgical Site Infections: A Systematic Review of Cost Analyses in the Use of Prophylactic Antibiotics

Development of a Clinical Practice Guideline for Lower Limb Amputees. A Knowledge Translation Process in a Middle Income Country

Risk factors for reamputation in patients with diabetic foot: A case-control study

Contact Info

Product

Resources

About