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Is Procalcitonin-Guided Antimicrobial Use Cost-Effective in Adult Patients with Suspected Bacterial Infection and Sepsis? Michelle Harrison and Curtis D. Collins Infection Control & Hospital Epidemiology / Volume 36 / Issue 03 / March 2015, pp 265 - 272 DOI: 10.1017/ice.2014.60, Published online: 05 January 2015
Link to this article: http://journals.cambridge.org/abstract_S0899823X14000609 How to cite this article: Michelle Harrison and Curtis D. Collins (2015). Is Procalcitonin-Guided Antimicrobial Use Cost-Effective in Adult Patients with Suspected Bacterial Infection and Sepsis?. Infection Control & Hospital Epidemiology, 36, pp 265-272 doi:10.1017/ ice.2014.60 Request Permissions : Click here
Downloaded from http://journals.cambridge.org/ICE, IP address: 203.64.11.45 on 30 Mar 2015
infection control & hospital epidemiology
march 2015, vol. 36, no. 3
original article
Is Procalcitonin-Guided Antimicrobial Use Cost-Effective in Adult Patients with Suspected Bacterial Infection and Sepsis? Michelle Harrison, PharmD;1 Curtis D. Collins, PharmD, MS, BCPS AQ-ID, FASHP1
objective. Procalcitonin has emerged as a promising biomarker of bacterial infection. Published literature demonstrates that use of procalcitonin testing and an associated treatment pathway reduces duration of antibiotic therapy without impacting mortality. The objective of this study was to determine the financial impact of utilizing a procalcitonin-guided treatment algorithm in hospitalized patients with sepsis. design. patients.
Cost-minimization and cost-utility analysis. Hypothetical cohort of adult ICU patients with suspected bacterial infection and sepsis.
methods. Utilizing published clinical and economic data, a decision analytic model was developed from the U.S. hospital perspective. Effectiveness and utility measures were defined using cost-per-clinical episode and cost per quality-adjusted life years (QALYs). Upper and lower sensitivity ranges were determined for all inputs. Univariate and probabilistic sensitivity analyses assessed the robustness of our model and variables. Incremental cost-effectiveness ratios (ICERs) were calculated and compared to predetermined willingness-to-pay thresholds. results. Base-case results predicted the use of a procalcitonin-guided treatment algorithm dominated standard care with improved quality (0.0002 QALYs) and decreased overall treatment costs ($65). The model was sensitive to a number of key variables that had the potential to impact results, including algorithm adherence ($46), days of antimicrobial reduction (
Control & Hospital Epidemiology:
Email alerts: Click here Subscriptions: Click here Commercial reprints: Click here Terms of use : Click here
Is Procalcitonin-Guided Antimicrobial Use Cost-Effective in Adult Patients with Suspected Bacterial Infection and Sepsis? Michelle Harrison and Curtis D. Collins Infection Control & Hospital Epidemiology / Volume 36 / Issue 03 / March 2015, pp 265 - 272 DOI: 10.1017/ice.2014.60, Published online: 05 January 2015
Link to this article: http://journals.cambridge.org/abstract_S0899823X14000609 How to cite this article: Michelle Harrison and Curtis D. Collins (2015). Is Procalcitonin-Guided Antimicrobial Use Cost-Effective in Adult Patients with Suspected Bacterial Infection and Sepsis?. Infection Control & Hospital Epidemiology, 36, pp 265-272 doi:10.1017/ ice.2014.60 Request Permissions : Click here
Downloaded from http://journals.cambridge.org/ICE, IP address: 203.64.11.45 on 30 Mar 2015
infection control & hospital epidemiology
march 2015, vol. 36, no. 3
original article
Is Procalcitonin-Guided Antimicrobial Use Cost-Effective in Adult Patients with Suspected Bacterial Infection and Sepsis? Michelle Harrison, PharmD;1 Curtis D. Collins, PharmD, MS, BCPS AQ-ID, FASHP1
objective. Procalcitonin has emerged as a promising biomarker of bacterial infection. Published literature demonstrates that use of procalcitonin testing and an associated treatment pathway reduces duration of antibiotic therapy without impacting mortality. The objective of this study was to determine the financial impact of utilizing a procalcitonin-guided treatment algorithm in hospitalized patients with sepsis. design. patients.
Cost-minimization and cost-utility analysis. Hypothetical cohort of adult ICU patients with suspected bacterial infection and sepsis.
methods. Utilizing published clinical and economic data, a decision analytic model was developed from the U.S. hospital perspective. Effectiveness and utility measures were defined using cost-per-clinical episode and cost per quality-adjusted life years (QALYs). Upper and lower sensitivity ranges were determined for all inputs. Univariate and probabilistic sensitivity analyses assessed the robustness of our model and variables. Incremental cost-effectiveness ratios (ICERs) were calculated and compared to predetermined willingness-to-pay thresholds. results. Base-case results predicted the use of a procalcitonin-guided treatment algorithm dominated standard care with improved quality (0.0002 QALYs) and decreased overall treatment costs ($65). The model was sensitive to a number of key variables that had the potential to impact results, including algorithm adherence ($46), days of antimicrobial reduction (
