ANTIBIOTIC PROPHYLAXIS FOR SURGERY

A systematic review and economic model of switching from non-glycopeptide to glycopeptide antibiotic prophylaxis for surgery

Background

This project investigated the use of glycopeptide antibiotics for the prevention of postoperative infections, and particularly infections by bacteria which are resistant to antibiotics which are normally used (Methicillin Resistant Staphylococcus Aureus - MRSA). A systematic review of all good quality research that has investigated this question in different operations and hospital settings was undertaken. In addition the evidence for which strategy might provide best value for money was assessed, taking into account the risks and consequences of the transmission of MRSA and of bacteria also becoming resistant to glycopeptides.

Findings

There is not enough good evidence available to assist in decision-making about whether and when to change from non-glycopeptide to glycopeptide antibiotics for prophylaxis in surgery. There is also a lack of evidence about the cost-effectiveness of glycopeptide antibiotic prophylaxis in surgery.

Conducted by: Gillian Cranny1 , Rachel A Elliott2, Helen LA Weatherly3, Duncan Chambers1, Neil S Hawkins3, Lindsey Myers1, Mark Sculpher3, Alison Eastwood1

1 Centre for Reviews and Dissemination, University of York; 2 Division of Social Research in Medicines and Health, School of Pharmacy, University of Nottingham; 3 Centre for Health Economics, University of York

Further details

Project page on NIHR HTA Programme website

Publications

Chambers D, Worthy G, Myers L, Weatherly H, Elliott R, Hawkins N, Sculpher M, Eastwood A. Glycopeptide versus non-glycopeptide antibiotics for prophylaxis of surgical site infections: a systematic review. Surg Infect. 2010;11(5):455-62

Cranny G , Elliott R, Weatherly H, Chambers D, Hawkins N, Myers L, Sculpher M, Eastwood A. A systematic review and economic model of switching from non-glycopeptide to glycopeptide antibiotic prophylaxis for surgery. Health Technol Assess. 2008:12(1):1-168

Elliott RA, Weatherly HLA, Hawkins NS, Cranny G, Chambers D, Myers L, Eastwood A, Sculpher MJ. An economic model for the prevention of MRSA infections after surgery: non-glycopeptide or glycopeptide antibiotic prophylaxis? Eur J Health Econ. 2010; 11(1):57-66

Funding

Commissioned by the HTA Programme on behalf of NICE's Technology Assessment Report (TAR) process