Cost-effectiveness of the antimicrobial treatment for inpatients infected with Klebsiella pneumoniae carbapenemase: a systematic review protocol

Santos, Wendel Mombaque dos; Matuoka, Jéssica Yumi; Secoli, Sílvia Regina

doi:10.11124/jbisrir-2016-003332

Cited by 3 publications

(1 citation statement)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…( 13 ) The economic cost of therapy and the high mortality rates of KPC make this infection a relevant health problem. ( 14 – 16 )…”

Section: Introductionmentioning

confidence: 99%

Economic burden of inpatients infected with Klebsiella pneumoniae carbapenemase

Santos¹,

Secoli²

2019

Einstein (São Paulo)

Self Cite

View full text Add to dashboard Cite

Objective: To estimate the direct medical costs of drug therapy of Klebsiella pneumoniae carbapenemase (KPC) infection patients in hospital-based context. Methods: A cost-of-illness study conducted with a prospective cohort design with hospitalized adults infected by KPC. Data collection was performed using an instrument composed of sociodemographic data, clinical and prescription medication. Estimates of the direct costs associated to each treatment were derived from the payer's perspective, in the case of federal public hospitals from Brazil, and included only drug costs. These costs were based on the average price available at the Brazilian Price Database Health. No discount rate was used for the cost of drugs. The costs are calculate in American Dollar (US$). Results: A total of 120 inpatients participated of this study. The total drug cost of these inpatients was US$ 367,680.85. The systemic antimicrobial group was responsible for 59.5% of total costs. The direct drug cost per patients infected by KPC was conservatively estimated at nearly US$ 4,100.00, and about of 60% of costs occurred during the period of infection. Conclusion: The findings of our study indicate a thoughtful economic hazard posed by KPC that all healthcare sectors have to face. The increasing worldwide incidence of these bacteria represents a growing burden that most health systems are unable to deal with. There is an imperative need to develop protocols and new antimicrobials to treatment of KPC, aiming to rearrange resources to increase the effectiveness of healthcare services.

show abstract

“…( 13 ) The economic cost of therapy and the high mortality rates of KPC make this infection a relevant health problem. ( 14 – 16 )…”

Section: Introductionmentioning

confidence: 99%

Economic burden of inpatients infected with Klebsiella pneumoniae carbapenemase

Santos¹,

Secoli²

2019

Einstein (São Paulo)

Self Cite

View full text Add to dashboard Cite

show abstract

Cost-effectiveness of antimicrobial treatment for inpatients with carbapenem-resistant Klebsiella pneumoniae infection: a systematic review of economic evidence

Santos

Aromataris

Secoli

et al. 2019

JBI Database of Systematic Reviews and Implementation Reports

View full text Add to dashboard Cite

Objectives: The objective of this review was to evaluate the cost-effectiveness of antimicrobial therapy for patients with carbapenem-resistant Klebsiella pneumoniae infection. Introduction: Among the main multi-resistant microorganisms, carbapenem-resistant K. pneumoniae is responsible for the mortality of 40% of patients following 30 days of infection. Treatment for carbapenem-resistant K. pneumoniae infection entails the use of high-cost antimicrobials. Inappropriate use of antimicrobials can increase the cost of treatment fourfold. This review aimed to evaluate the cost-effectiveness of antimicrobial therapy treatment for patients with carbapenem-resistant K. pneumoniae infection to better inform decision making in hospital services. Inclusion criteria: The review included studies on participants 18 years or over with carbapenem-resistant K. pneumoniae infection who had undergone antimicrobial therapy in hospital and acute care services. Studies that compared the cost-effectiveness of different antimicrobial therapy for carbapenem-resistant K. pneumoniae infection were included. Outcome measures were cost per unit of effect expressed in clinical outcome units; this included cost per avoided death, cost per prevention of sepsis and cost per duration of stay. Economic studies with a cost-effectiveness design were considered, as well as modeling studies. Methods: A three-step search strategy was utilized to locate studies published in English, Spanish or Portuguese, with no date restrictions. Two independent reviewers screened titles and abstracts and the full texts of potentially relevant studies for eligibility. Methodological quality was assessed by two independent reviewers using the JBI critical appraisal checklist for economic evaluations. Data were extracted from included studies using the standardized JBI data extraction tool. Data were synthesized using narrative, tables and the JBI Dominance Ranking Matrix. Results: This review identified eight studies that evaluated the cost-effectiveness of different treatments for carbapenem-resistant K. pneumoniae infection. The results of this study demonstrated that there was no gold standard treatment for carbapenem-resistant K. pneumoniae infection, hence treatment was generally directed by colonization pressure and resistance profiles. Furthermore, due to the moderate quality and limited number of studies, there was high uncertainty of the values of the cost-effectiveness ratio. Conclusions: Ofloxacin appears to be the most cost-effective treatment; however, conclusions are limited due to the small number and low quality of studies.

show abstract

Investigation of the Relationship between Antibiotic Resistance and Biofilm Production in Klebsiella pneumoniae Isolated from Hamadan Hospitals, Iran

بیاتی¹,

حبیبیپور²,

اصغری³

2019

Avicenna J Clin Med

View full text Add to dashboard Cite

Background and Objective:The role of biofilm formation by bacteria has been considered as an important stage in the pathogenesis of Klebsiella pneumoniae. This pathogen is one of the most important opportunistic pathogen agents of nosocomial infections, such as pneumonia, urinary tract infections, invasive infections, and surgical site infections. This study aimed to investigate the biofilm producer strains among different clinical isolates of Klebsiella pneumoniae. Materials and Methods: This observational study was conducted on 230 clinical samples with bacterial infection. The selective culture media and biochemical tests were used for the identification of Klebsiella pneumoniae isolates. Crystal Violet assay and PCR were also used to characterize biofilm strains. Results: Out of 230 samples collected from different specimens, 100 isolates (43.47%) of Klebsiella pneumoniae were identified by biochemical tests. Of these, 58 (58%) and 42 isolates (42%) were isolated from the male and female individuals, respectively. The phenotypic method showed 2, 27, 41, and 30 isolates as strong biofilm producers, medium biofilm producers, weak biofilm producers, and non-biofilm producers, respectively. The frequency of genes were reported as wzm (47%), markA (69%), pgaAa (65%), and wbbm (47%), respectively. Conclusion:The markA gene plays an important role in biofilm formation and can identify different biofilms in Klebsiella pneumoniae strains. It is also possible to identify bacteria with weak, moderate, and strong biofilms.

show abstract

Cost-effectiveness of the antimicrobial treatment for inpatients infected with Klebsiella pneumoniae carbapenemase: a systematic review protocol

Cited by 3 publications

References 50 publications

Economic burden of inpatients infected with Klebsiella pneumoniae carbapenemase

Economic burden of inpatients infected with Klebsiella pneumoniae carbapenemase

Cost-effectiveness of antimicrobial treatment for inpatients with carbapenem-resistant Klebsiella pneumoniae infection: a systematic review of economic evidence

Investigation of the Relationship between Antibiotic Resistance and Biofilm Production in Klebsiella pneumoniae Isolated from Hamadan Hospitals, Iran

Contact Info

Product

Resources

About