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: CRD and the Centre for Health Economics, University of York
Commissioned by: HTA Programme
Current Status: Completed 2006

Publications:
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.