Cost effectiveness of selective decontamination of the digestive tract in liver transplant patients

To assess the cost effectiveness of selective decontamination of the digestive tract (SDD) in liver transplant patients. Randomised, placebo-controlled, double-blind trial with an integrated economic evaluation. Two university hospitals in The Netherlands. Cost effectiveness was assessed from a soci...

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Bibliographic Details
Published in:PharmacoEconomics 2001, Vol.19 (5 Pt 1), p.523-530
Main Authors: van Enckevort, P J, Zwaveling, J H, Bottema, J T, Maring, J K, Klompmaker, I J, Slooff, M J, TenVergert, E M
Format: Article
Language:English
Subjects:
Adult
Amphotericin B
Anti-Bacterial Agents - economics
Anti-Bacterial Agents - therapeutic use
Colistin
Cost analysis
Cost-Benefit Analysis
Digestive System - microbiology
Double-Blind Method
Female
Health technology assessment
Humans
Length of Stay
Liver transplant
Liver Transplantation - economics
Male
Netherlands
Norfloxacin
Pharmacoeconomics
Postoperative Complications - economics
Postoperative Complications - prevention & control
Postoperative infections
Surgical Wound Infection - prevention & control
Tobramycin
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Summary:To assess the cost effectiveness of selective decontamination of the digestive tract (SDD) in liver transplant patients. Randomised, placebo-controlled, double-blind trial with an integrated economic evaluation. Two university hospitals in The Netherlands. Cost effectiveness was assessed from a societal perspective. 58 patients who underwent liver transplantation and received SDD (n = 29) or placebo (n = 29) pre- and postoperatively. SDD medication and placebo. Infection episodes, days of infection, costs of SDD and routine cultures, mean other direct medical costs per patient and additional costs of severe infection. Costs of SDD medicine and routine cultures were on average 3,100 US dollars ($US; 1997 values) per patient who underwent SDD. Both preoperatively and postoperatively, costs other than SDD and cultures did not significantly differ between the SDD and the placebo groups (preoperative, $US2,370 vs $US2,590; postoperative, $US25,455 vs $US24,915). Additional postoperative costs of severe infections were $US250 per day per patient. There were no significant differences in the mean number of infection episodes between groups. SDD leads to the additional costs of SDD medication and routine cultures, whereas no savings in other costs and no improvement in infection episodes are realised. Consequently, SDD may be considered as a nonefficient approach in patients undergoing liver transplantation. The additional costs of severe infection are considerable.
ISSN:1170-7690
1179-2027
DOI:10.2165/00019053-200119050-00007