1Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
2Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok, 10400 Thailand.
Antimicrob Resist Infect Control. 2018 Oct 4;7:119. doi: 10.1186/s13756-018-0414-1. eCollection 2018.
We assess the cost-benefit implications of C-reactive protein (CRP) testing in reducing antibiotic prescription for acute respiratory infection in Viet Nam by comparing the incremental costs of CRP testing with the economic costs of antimicrobial resistance averted due to lower antibiotic prescribing.
Patients in the CRP group and the controls incurred similar costs in managing their illness, excluding the costs of the quantitative CRP tests, provided free of charge in the trial context. Assuming a unit cost of $1 per test, the incremental cost of CRP testing was $0.93 per patient. Based on a previous modelling analysis, the 20 percentage point reduction in prescribing observed in the trial implies a societal benefit of $0.82 per patient. With the low levels of adherence to the test results observed in the trial, CRP testing would not be cost-beneficial. The sensitivity analyses showed, however, that with higher adherence to test results their use would be cost-beneficial.
通过比较 C 反应蛋白（CRP）检测在降低急性呼吸道感染抗生素处方方面的成本效益，评估 CRP 检测在越南减少抗生素处方的成本效益，从而避免因抗生素使用减少而产生的抗生素耐药性的经济成本。
在试验背景下，CRP 组和对照组的患者在管理其疾病方面的成本相似，不包括定量 CRP 检测的成本。假设检测费用为 1 美元/次，每位患者的 CRP 检测的增量成本为 0.93 美元。根据之前的模型分析，试验中观察到的 20%的抗生素处方减少率意味着每位患者的社会效益为 0.82 美元。考虑到试验中观察到的对检测结果的低依从性，CRP 检测的成本效益不佳。然而，敏感性分析表明，如果对检测结果的依从性更高，使用 CRP 检测将具有成本效益。
