Spontaneous bacterial peritonitis cost-effectiveness of therapy: Difference between revisions
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* Norfloxacin prophylaxis resulted in savings between $2216 and $8545 per patient per year, depending on the patient group studied. | * Norfloxacin prophylaxis resulted in savings between $2216 and $8545 per patient per year, depending on the patient group studied. | ||
* Trimethoprim-sulfamethoxazole prophylaxis resulted in savings between $2934 and $9251 per patient per year. <ref>http://www.ncbi.nlm.nih.gov/pubmed?term=9322524</ref> | * Trimethoprim-sulfamethoxazole prophylaxis resulted in savings between $2934 and $9251 per patient per year. <ref>http://www.ncbi.nlm.nih.gov/pubmed?term=9322524</ref> | ||
* Abdominal [[paracentesis]] with appropriate ascitic fluid analysis is probably the most rapid and cost-effective method of diagnosing the cause of [[ascites]] | |||
* Regular infusions of [[albumin]] for treatment of new-onset or [[refractory ascites]] should be considered experimental until more studies demonstrate efficacy and cost-effectiveness. | |||
* Intravenous ciprofloxacin followed by oral administration of this drug was found to be more cost-effective compared to intravenous ceftazidime in a randomized trial in patients who had not received quinolone prophylaxis. | |||
* Selective intestinal decontamination with norfloxacin or trimethoprim/sulfamethoxazole in patients with prior spontaneous bacterial peritonitis (SBP) or low-protein ascitic fluid does appear to be cost-effective. <ref>http://guideline.gov/content.aspx?id=14887&search=ascitis</ref> | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} |
Revision as of 21:44, 1 August 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]
Overview
The use of prophylactic antibiotics to decrease the incidence of spontaneous bacterial peritonits is a cost-saving strategy in patients with cirrhosis and ascites.
Cost-Effectiveness of Therapy
- Norfloxacin prophylaxis resulted in savings between $2216 and $8545 per patient per year, depending on the patient group studied.
- Trimethoprim-sulfamethoxazole prophylaxis resulted in savings between $2934 and $9251 per patient per year. [1]
- Abdominal paracentesis with appropriate ascitic fluid analysis is probably the most rapid and cost-effective method of diagnosing the cause of ascites
- Regular infusions of albumin for treatment of new-onset or refractory ascites should be considered experimental until more studies demonstrate efficacy and cost-effectiveness.
- Intravenous ciprofloxacin followed by oral administration of this drug was found to be more cost-effective compared to intravenous ceftazidime in a randomized trial in patients who had not received quinolone prophylaxis.
- Selective intestinal decontamination with norfloxacin or trimethoprim/sulfamethoxazole in patients with prior spontaneous bacterial peritonitis (SBP) or low-protein ascitic fluid does appear to be cost-effective. [2]