The Library
Prophylactic antibiotics to prevent cellulitis of the leg : economic analysis of the PATCH I & II trials
Tools
Tools
Tools
Mason, James, Thomas, Kim S., Crook, Angela M., Foster, Katharine A., Chalmers, Joanne R., Nunn, Andrew J. and Williams, Hywel C. (2014) Prophylactic antibiotics to prevent cellulitis of the leg : economic analysis of the PATCH I & II trials. PLoS One, 9 (2). e82694. doi:10.1371/journal.pone.0082694
Research output not available from this repository, contact author.
Official URL: http://dx.doi.org/10.1371/journal.pone.0082694
Abstract
Background: Cellulitis (erysipelas) is a recurring and debilitating bacterial infection of the skin and underlying tissue. We assessed the cost-effectiveness of prophylactic antibiotic treatment to prevent the recurrence of cellulitis using low dose penicillin V in patients following a first episode (6 months prophylaxis) and more recurrent cellulitis (12 months prophylaxis, or 6 months in those declining 12 months).
Methods: Within-trial cost-effectiveness analysis was conducted using the findings of two randomised placebo-controlled multicentre trials (PATCH I and PATCH II), in which patients recruited in the UK and Ireland were followed-up for up to 3 years. Incremental cost, reduction in recurrence, cost per recurrence prevented and cost/QALY were estimated. National unit and reference costs for England in 2010 were applied to resource use, exploring NHS and societal perspectives. A total of 397 patients from the two trials contributed to the analysis.
Results: There was a 29% reduction in the number of recurrences occurring within the trial (IRR: 0.71 95%CI: 0.53 to 0.90, p = 0.02), corresponding to an absolute reduction of recurrence of 0.31 recurrences/patient (95%CI: 0.05 to 0.59, p = 0.02). Incremental costs of prophylaxis suggested a small cost saving but were not statistically significant, comparing the two groups. If a decision-maker is willing to pay up to £25,000/QALY then there is a 66% probability of antibiotic prophylaxis being cost-effective from an NHS perspective, rising to 76% probability from a secondary, societal perspective.
Conclusion: Following first episode or recurrent cellulitis of the leg, prophylactic low dose penicillin is a very low cost intervention which, on balance, is effective and cost-effective at preventing subsequent attacks. Antibiotic prophylaxis reduces cellulitis recurrence by nearly a third but is not associated with a significant increase in costs.
| Item Type: | Journal Article | ||||||
|---|---|---|---|---|---|---|---|
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
||||||
| Journal or Publication Title: | PLoS One | ||||||
| Publisher: | Public Library of Science | ||||||
| ISSN: | 1932-6203 | ||||||
| Official Date: | 14 February 2014 | ||||||
| Dates: |
|
||||||
| Volume: | 9 | ||||||
| Number: | 2 | ||||||
| Article Number: | e82694 | ||||||
| DOI: | 10.1371/journal.pone.0082694 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access |
Request changes or add full text files to a record
Repository staff actions (login required)
 |
View Item |
