Institute of Health Care Management, Department of Law and Economics, University of Greifswald, Friedrich-Loeffler-Str. 70, 17489, Greifswald, Germany.
Eur J Clin Microbiol Infect Dis. 2012 Nov;31(11):3065-72. doi: 10.1007/s10096-012-1666-y. Epub 2012 Jun 15.
The aim of this study is to examine whether rapid polymerase chain reaction (PCR)-based screening is a cost-efficient tool to optimize pre-emptive antibiotic therapy of methicillin-resistant and methicillin-sensitive Staphylococcus aureus (MRSA and MSSA, respectively) infections. A decision analytic cost model was developed, based on data from the peer-reviewed literature. Sensitivity analyses were undertaken to investigate the impact of variation in the MRSA rate, cost ratio of the cost of inappropriate antibiotic therapy to the cost of appropriate antibiotic therapy, PCR test cost, and total hospital costs per case. At a current MRSA rate of 24.5 % in Germany, PCR-guided treatment regimens are cost-efficient compared to empirical strategies. The costs of alternative treatment strategies differ, on average, up to 1,780
本研究旨在探讨基于聚合酶链反应（PCR）的快速筛查是否是优化耐甲氧西林金黄色葡萄球菌（MRSA）和甲氧西林敏感金黄色葡萄球菌（MSSA）感染的预防性抗生素治疗的一种具有成本效益的工具。基于同行评议文献中的数据，开发了一种决策分析成本模型。进行了敏感性分析，以调查 MRSA 发生率、不适当抗生素治疗成本与适当抗生素治疗成本之比、PCR 检测成本以及每例患者总住院费用的变化对结果的影响。在德国目前 24.5%的 MRSA 发生率下，与经验性策略相比，PCR 指导的治疗方案具有成本效益。替代治疗策略的成本平均差异高达每例 1780 欧元。当成本比小于 1.06 时，经验性 MRSA 治疗策略的成本最低。当每例 MRSA 患者的总住院费用增加时，使用 PCR 检测进行预防性 MSSA 治疗可实现最低的平均成本。在德国和其他欧洲国家，使用基于 PCR 的检测方法早期验证和调整金黄色葡萄球菌感染的初始预防性抗生素治疗具有优势。因此，PCR 检测应被视为抗菌药物管理计划的要素。
