La profilassi antibiotica in chirurgia e la sua valutazione economica

Abstract

Surgical wound infections (SWIs) are a subset of hospital acquired infections (HAIs), associated – though not to the highest frequency – to the highest cost share within HAIs. On these grounds, an economic approach to their entity (incidence and costs) and to the clinical means (surgical prophylaxis) for their containment is attempted in this article. In particular, a simple model is reported to evaluate the best effectiveness of alternative regimens, based on the following equation: Diff Cost = Cost SWI x Diff WIR. Where Diff Cost = difference in the costs of the prophylactic regimens in comparison. Cost SWI = cost per wound infection. Diff Wir = difference in the efficacy of regimens, measured as the difference in Wound Infection Rate. Such equation computes points of indifference, that is points where the difference in efficacy is balanced by the difference in cost between two treatments. At a bit more sophisticated level, this model can be used by adding some stochastic components (confidence intervals). This article collects a group of case-studies, relative to which the model is applied and discussed.