TY - JOUR
T1 - The Cost-effectiveness of Antimicrobial Lock Solutions for the Prevention of Central Line-Associated Bloodstream Infections
AU - Pliakos, Elina Eleftheria
AU - Andreatos, Nikolaos
AU - Ziakas, Panayiotis D.
AU - Mylonakis, Eleftherios
N1 - Publisher Copyright:
© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved.
PY - 2019/1/18
Y1 - 2019/1/18
N2 - Antimicrobial lock solutions are a low-cost strategy that can reduce the incidence of central line-associated bloodstream infection (CLABSI). The aim of this study was to evaluate the cost-effectiveness of antimicrobial locks for the prevention of CLABSI. Methods. We constructed a decision-analytic model comparing antimicrobial lock solutions to heparin locks for the prevention of CLABSI in 3 settings: hemodialysis, cancer treatment, and home parenteral nutrition. Cost-effectiveness was determined by calculating CLABSIs prevented and incremental cost-effectiveness ratios. Uncertainty was addressed by plotting cost-effectiveness planes and acceptability curves for various willingness-to-pay thresholds. Results. In probabilistic analysis, at a willingness to pay of 50 000, antimicrobial lock solutions had a 96.24% chance of being cost-effective, compared with heparin locks in the hemodialysis setting, an 88.00% chance in the cancer treatment setting, and a 92.73% chance in the home parenteral nutrition setting. In base-case analysis, antimicrobial lock solutions resulted in savings of 68 721.03 for the hemodialysis setting, 85 061.41 for the cancer setting, and 78 513.83 for the home parenteral nutrition setting per CLABSI episode prevented. Conclusions. In 3 distinct and clinically important settings (hemodialysis, cancer treatment, and home parenteral nutrition), antimicrobial lock solutions are an effective strategy for the prevention of CLABSI, and their use can result in significant healthcare savings.
AB - Antimicrobial lock solutions are a low-cost strategy that can reduce the incidence of central line-associated bloodstream infection (CLABSI). The aim of this study was to evaluate the cost-effectiveness of antimicrobial locks for the prevention of CLABSI. Methods. We constructed a decision-analytic model comparing antimicrobial lock solutions to heparin locks for the prevention of CLABSI in 3 settings: hemodialysis, cancer treatment, and home parenteral nutrition. Cost-effectiveness was determined by calculating CLABSIs prevented and incremental cost-effectiveness ratios. Uncertainty was addressed by plotting cost-effectiveness planes and acceptability curves for various willingness-to-pay thresholds. Results. In probabilistic analysis, at a willingness to pay of 50 000, antimicrobial lock solutions had a 96.24% chance of being cost-effective, compared with heparin locks in the hemodialysis setting, an 88.00% chance in the cancer treatment setting, and a 92.73% chance in the home parenteral nutrition setting. In base-case analysis, antimicrobial lock solutions resulted in savings of 68 721.03 for the hemodialysis setting, 85 061.41 for the cancer setting, and 78 513.83 for the home parenteral nutrition setting per CLABSI episode prevented. Conclusions. In 3 distinct and clinically important settings (hemodialysis, cancer treatment, and home parenteral nutrition), antimicrobial lock solutions are an effective strategy for the prevention of CLABSI, and their use can result in significant healthcare savings.
KW - CLABSI
KW - cost-effectiveness
KW - lock.
UR - http://www.scopus.com/inward/record.url?scp=85060157544&partnerID=8YFLogxK
U2 - 10.1093/cid/ciy511
DO - 10.1093/cid/ciy511
M3 - Article
C2 - 29945237
AN - SCOPUS:85060157544
SN - 1058-4838
VL - 68
SP - 419
EP - 425
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 3
ER -