Lundberg J, Nettleman M D, Costigan M, Bentler S, Dawson J, Wenzel R P
Virginia Commonwealth University, Medical College of Virginia, Richmond 23298, USA.
Clin Perform Qual Health Care. 1998 Jan-Mar;6(1):9-11.
To investigate the cost-effectiveness of long-term therapy for Staphylococcus aureus bacteremia and to determine if an infectious diseases consultation affected the duration of therapy.
A decision analysis was performed based on data from the literature. To determine if consultation was related to therapy duration, a retrospective cohort study was performed using tightly matched pairs.
The excess cost per life saved by long-term antibiotics was $500,000. The excess cost per life-year saved was $18,000. Nine pairs were matched. Patients who received consultation were more likely to receive long-term therapy than controls (median 41 days vs 15 days for controls, P = .04).
The estimated cost per life-year saved by long-term therapy was similar to other accepted medical interventions. Infectious diseases consultation can encourage prolonged duration of antibiotic therapy for S aureus bacteremia.
探讨金黄色葡萄球菌菌血症长期治疗的成本效益，并确定感染病会诊是否会影响治疗时长。
基于文献数据进行决策分析。为确定会诊是否与治疗时长相关，采用严格匹配对进行回顾性队列研究。
长期使用抗生素挽救每一条生命的额外成本为50万美元。每挽救一个生命年的额外成本为18,000美元。匹配了9对。接受会诊的患者比对照组更有可能接受长期治疗（中位数分别为41天和15天，P = 0.04）。
长期治疗每挽救一个生命年的估计成本与其他公认的医疗干预措施相似。感染病会诊可促使延长金黄色葡萄球菌菌血症的抗生素治疗时长。
