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Cost impact of procalcitonin-guided decision making on duration of antibiotic therapy for suspected early-onset sepsis in neonates

AJLM. Geraerds, W. van Herk, M. Stocker, S. El Helou, S. Dutta, MS. Fontana, FABA. Schuerman, RK. van den Tooren-de Groot, J. Wieringa, J. Janota, LH. van der Meer-Kappelle, R. Moonen, SD. Sie, E. de Vries, AE. Donker, U. Zimmerman, LJ....

. 2021 ; 25 (1) : 367. [pub] 20211020

Jazyk angličtina Země Velká Británie

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc22003437

BACKGROUNDS: The large, international, randomized controlled NeoPInS trial showed that procalcitonin (PCT)-guided decision making was superior to standard care in reducing the duration of antibiotic therapy and hospitalization in neonates suspected of early-onset sepsis (EOS), without increased adverse events. This study aimed to perform a cost-minimization study of the NeoPInS trial, comparing health care costs of standard care and PCT-guided decision making based on the NeoPInS algorithm, and to analyze subgroups based on country, risk category and gestational age. METHODS: Data from the NeoPInS trial in neonates born after 34 weeks of gestational age with suspected EOS in the first 72 h of life requiring antibiotic therapy were used. We performed a cost-minimization study of health care costs, comparing standard care to PCT-guided decision making. RESULTS: In total, 1489 neonates were included in the study, of which 754 were treated according to PCT-guided decision making and 735 received standard care. Mean health care costs of PCT-guided decision making were not significantly different from costs of standard care (€3649 vs. €3616). Considering subgroups, we found a significant reduction in health care costs of PCT-guided decision making for risk category 'infection unlikely' and for gestational age ≥ 37 weeks in the Netherlands, Switzerland and the Czech Republic, and for gestational age < 37 weeks in the Czech Republic. CONCLUSIONS: Health care costs of PCT-guided decision making of term and late-preterm neonates with suspected EOS are not significantly different from costs of standard care. Significant cost reduction was found for risk category 'infection unlikely,' and is affected by both the price of PCT-testing and (prolonged) hospitalization due to SAEs.

Department of Neonatology Albert Schweitzer Hospital Dordrecht The Netherlands

Department of Neonatology Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam The Netherlands

Department of Neonatology Reinier de Graaf Gasthuis Delft The Netherlands

Department of Neonatology Sint Franciscus Gasthuis Rotterdam The Netherlands

Department of Neonatology St Josephs Healthcare Hamilton Health Sciences Hamilton ON Canada

Department of Neonatology Zuyderland Medical Centre Heerlen The Netherlands

Department of Paediatrics Bern University Hospital Inselspital University of Bern Bern Switzerland

Department of Paediatrics Haaglanden Medical Center 's Gravenhage The Netherlands

Department of Paediatrics Jeroen Bosch Hospital 's Hertogenbosch The Netherlands

Department of Paediatrics Kantonsspital Winterthur Winterthur Switzerland

Department of Paediatrics Maxima Medical Centre Veldhoven The Netherlands

Department of Paediatrics Neonatal and Paediatric Intensive Care Unit Children's Hospital Lucerne Lucerne Switzerland

Department of Paediatrics Stadtspital Triemli Zürich Switzerland

Department of Public Health Erasmus MC University Medical Center Rotterdam P O Box 2040 3000 CA Rotterdam The Netherlands

Division of Neonatology Erasmus MC University Medical Centre Sophia Children's Hospital Rotterdam The Netherlands

Division of Neonatology McMaster University Children's Hospital Hamilton Health Sciences Hamilton ON Canada

Division of Paediatric Infectious Diseases and Immunology Department of Paediatrics Erasmus MC University Medical Centre Sophia Children's Hospital Rotterdam The Netherlands

Institute of Pathological Physiology 1st Medical Faculty Charles University Prague Czech Republic

Julius Training General Practitioner University Medical Centre Utrecht Utrecht The Netherlands

Neonatal Intensive Care Unit Isala Women and Children's Centre Isala Hospital Zwolle The Netherlands

Neonatal Unit Department of Obstetrics and Gynaecology Motol University Hospital 2nd Medical Faculty Charles University Prague Czech Republic

Paediatric Critical Care Research Group Mater Research Institute University of Queensland Brisbane QLD Australia

Paediatric Intensive Care Unit Lady Cilento Children's Hospital Brisbane QLD Australia

Citace poskytuje Crossref.org

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