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 Eastwood11. Centre for Reviews and Dissemination; 2. Division of Social Research in Medicines and Health, School of Pharmacy, University of Nottingham; 3. Centre for Health Economics
Further details
Project page on NIHR HTA Programme websitePublications
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):57-66Funding
Commissioned by the HTA Programme on behalf of NICE's Technology Assessment Report (TAR) process