Diagnostic Testing for Sepsis: A Systematic Review of Economic Evaluations

Rojas-Garcia, Paula; Pol, S.; Asselt, Antoinette D. I. van; Postma, Maarten; Rodríguez–Ibeas, Roberto; Juárez-Castelló, Carmelo; González, M. J. Ruiz; Antoñanzas, Fernando

doi:10.3390/antibiotics11010027

Cited by 2 publications

(2 citation statements)

References 52 publications

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“…Probably, the first study evaluating the cost-effectiveness of PCT was the ProCAP study [ 94 ] showing that the cost of antibiotics plus PCT measurement was significantly higher in the intervention arm. However, the cost of PCT measurement decreased overtime and a recent systematic review and meta-analysis showed that monitoring of PCT was cost saving [ 95 ]. These findings have been challenged by studies with real world data [ 96 , 97 ] showing that PCT monitoring was associated with potential increase in antibiotic days and LOS.…”

Section: Host-response Biomarkersmentioning

confidence: 99%

Biomarkers in pulmonary infections: a clinical approach

Póvoa,

Coelho,

Cidade

et al. 2024

Ann. Intensive Care

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Severe acute respiratory infections, such as community-acquired pneumonia, hospital-acquired pneumonia, and ventilator-associated pneumonia, constitute frequent and lethal pulmonary infections in the intensive care unit (ICU). Despite optimal management with early appropriate empiric antimicrobial therapy and adequate supportive care, mortality remains high, in part attributable to the aging, growing number of comorbidities, and rising rates of multidrug resistance pathogens. Biomarkers have the potential to offer additional information that may further improve the management and outcome of pulmonary infections. Available pathogen-specific biomarkers, for example, Streptococcus pneumoniae urinary antigen test and galactomannan, can be helpful in the microbiologic diagnosis of pulmonary infection in ICU patients, improving the timing and appropriateness of empiric antimicrobial therapy since these tests have a short turnaround time in comparison to classic microbiology. On the other hand, host-response biomarkers, for example, C-reactive protein and procalcitonin, used in conjunction with the clinical data, may be useful in the diagnosis and prediction of pulmonary infections, monitoring the response to treatment, and guiding duration of antimicrobial therapy. The assessment of serial measurements overtime, kinetics of biomarkers, is more informative than a single value. The appropriate utilization of accurate pathogen-specific and host-response biomarkers may benefit clinical decision-making at the bedside and optimize antimicrobial stewardship.

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Section: Host-response Biomarkersmentioning

confidence: 99%

Biomarkers in pulmonary infections: a clinical approach

Póvoa,

Coelho,

Cidade

et al. 2024

Ann. Intensive Care

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“…Previously, few economic analyses in the field of diagnostics for infectious diseases incorporated considerations of AMR [45][46][47]. The relative reduction of AMR in the analysis shows considerable uncertainty and there are some important assumptions to consider when interpreting these results.…”

Section: Fig 4 Development Of Antimicrobial Resistance For Both Scena...mentioning

confidence: 99%

The Opportunity of Point-of-Care Diagnostics in General Practice: Modelling the Effects on Antimicrobial Resistance

et al. 2022

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Objectives Antimicrobial resistance (AMR) is a public health threat associated with antibiotic consumption. Community-acquired acute respiratory tract infections (CA-ARTIs) are a major driver of antibiotic consumption in primary care. We aimed to quantify the investments required for a large-scale rollout of point-of care (POC) diagnostic testing in Dutch primary care, and the impact on AMR due to reduced use of antibiotics. Methods We developed an individual-based model that simulates consultations for CA-ARTI at GP practices in the Netherlands and compared a scenario where GPs test all CA-ARTI patients with a hypothetical diagnostic strategy to continuing the current standard-of-care for the years 2020–2030. We estimated differences in costs and future AMR rates caused by testing all patients consulting for CA-ARTI with a hypothetical diagnostic strategy, compared to the current standard-of-care in GP practices. Results Compared to the current standard-of-care, the diagnostic algorithm increases the total costs of GP consultations for CA-ARTI by 9% and 19%, when priced at €5 and €10, respectively. The forecast increase in Streptococcus pneumoniae resistance against penicillins can be partly restrained by the hypothetical diagnostic strategy from 3.8 to 3.5% in 2030, albeit with considerable uncertainty. Conclusions Our results show that implementing a hypothetical diagnostic strategy for all CA-ARTI patients in primary care raises the costs of consultations, while lowering antibiotic consumption and AMR. Novel health-economic methods to assess and communicate the potential benefits related to AMR may be required for interventions with limited gains for individual patients, but considerable potential related to antibiotic consumption and AMR.

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Diagnostic Testing for Sepsis: A Systematic Review of Economic Evaluations

Cited by 2 publications

References 52 publications

Biomarkers in pulmonary infections: a clinical approach

Biomarkers in pulmonary infections: a clinical approach

The Opportunity of Point-of-Care Diagnostics in General Practice: Modelling the Effects on Antimicrobial Resistance

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