Economic evaluation of treatment for MRSA complicated skin and soft tissue infections in Glasgow hospitals

Abstract

In the UK, methicillin-resistant Staphylococcus aureus (MRSA)-associated skin and soft tissue infections (SSTIs) are predominantly managed in the hospital using intravenous (IV) glycopeptides. We set out to explore the potential for and relative healthcare costs of earlier hospital discharge through switch to oral antibiotic therapy (linezolid or rifampicin and doxycycline) or continuation of IV therapy (teicoplanin) via an outpatient parenteral antimicrobial therapy (OPAT) service. Over 16 months, 173 patients were retrospectively identified with MRSA SSTI, of whom 82.8 % were treated with IV therapy. Thirty-seven patients were potentially suitable for earlier discharge with outpatient therapy. The model assumed 3 days of inpatient management and a maximum of 14 days of outpatient therapy. For the status quo, where patients received only inpatient care with IV therapy, hospital costs were calculated at £12,316 per patient, with 97 % of costs accounted for by direct bed day costs. The mean total cost savings achievable through OPAT or oral therapy was estimated to be £6,136 and £6,159 per patient treated, respectively. A significant proportion of patients with MRSA SSTI may be suitable for outpatient management with either oral therapy or via OPAT, with the potential for significant reduction in healthcare costs.

The Community IntraVenous Antibiotic Study (CIVAS): a mixed-methods evaluation of patient preferences for and cost-effectiveness of different service models for delivering outpatient parenteral antimicrobial therapy

“…service comparators, including inpatient care and early discharge with oral treatment. The patient populations were varied too, including those with surgical site infections, 66 MRSA-complicated SSTIs, 136 cystic fibrosis, 53 febrile neutropenia 65 and prosthetic joint infections. 24 Of the studies identified in the review, only one presented an incremental cost-utility analysis.…”

Antibacterial Treatment of Meticillin-Resistant Staphylococcus Aureus Complicated Skin and Soft Tissue Infections: a Cost and Budget Impact Analysis in Greek Hospitals

“…Moreover, the option of outpatient oral and IV treatment continuation was not taken into consideration as this falls beyond the scope of the study (hospital setting). However, this could have a substantial impact on total cost of treatment [ 33 ], especially from an overall healthcare system perspective. Recent evidence shows that the administration of antibacterial treatment administered on an outpatient basis can reduce per patient costs up to 30% [ 19 ].…”

Costo-utilità di dalbavancina versus standard of care (SoC) in pazienti con ABSSSI non severa in Italia

“…Il trattamento di pazienti affetti da ABSSSI richiede tempi di ospedalizzazione molto lunghi che, oltre ad apportare un peggioramento alla qualità di vita del paziente stesso, comportano costi elevati per il SSN. Uno studio retrospettivo, condotto negli Stati Uniti su pazienti con diagnosi di ABSSSI da S. aureus, ha stimato una degenza media per paziente di circa 6 giorni (19).…”