Diagnostic Testing for Sepsis: A Systematic Review of Economic Evaluations

Paula Rojas-Garcia*, Simon van der Pol, Antoinette D. I. van Asselt, Maarten J. Postma, Roberto Rodriguez-Ibeas, Carmelo A. Juarez-Castello, Marino Gonzalez, Fernando Antonanzas

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

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Abstract

Introduction: Sepsis is a serious and expensive healthcare problem, when caused by a multidrug-resistant (MDR) bacteria mortality and costs increase. A reduction in the time until the start of treatment improves clinical results. The objective is to perform a systematic review of economic evaluations to analyze the cost-effectiveness of diagnostic methods in sepsis and to draw lessons on the methods used to incorporate antimicrobial resistance (AMR) in these studies. Material and Methods: the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the Consolidated Health Economic Evaluation Reporting standards (CHEERS) checklist was used to extract the information from the texts. Results: A total of 16 articles were found. A decision model was performed in 14. We found two ways to handle resistance while modelling: the test could identify infections caused by a resistant pathogen or resistance-related inputs, or outcomes were included (the incidence of AMR in sepsis patients, antibiotic use, and infection caused by resistant bacterial pathogens). Conclusion: Using a diagnostic technique to detect sepsis early on is more cost-effective than standard care. Setting a direct relationship between the implementation of a testing strategy and the reduction of AMR cases, we made several assumptions about the efficacy of antibiotics and the length-of-stay of patients.

Original languageEnglish
Article number27
Number of pages15
JournalAntibiotics
Volume11
Issue number1
DOIs
Publication statusPublished - Jan-2022

Keywords

  • sepsis
  • antibiotics
  • diagnostic testing
  • AMR
  • systematic review
  • SUSPECTED BACTERIAL-INFECTION
  • COST-EFFECTIVENESS
  • CLINICAL-TRIALS
  • ANTIBIOTIC-THERAPY
  • ADULT PATIENTS
  • SEPTIC SHOCK
  • PROCALCITONIN
  • PERFORMANCE
  • MORTALITY
  • IMPACT

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