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ARTICLE |

The Cost of Prevention: Common Sense and Decision Trees FREE

William E. Scheckler, MD
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Address editorial communications to the Editor, 535 N Dearborn St, Chicago, IL 60610.


JAMA. 1983;249(10):1328-1328. doi:10.1001/jama.1983.03330340070037
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In this issue of The Journal (page 1290), Shapiro and colleagues have constructed a promising benefit-cost analysis of surgical antimicrobial prophylaxis. Numerous studies in recent years indicate that 30% to 50% of total in-hospital antibiotic use, especially the cephalosporin group of drugs, is given for prevention of postoperative infection.1 It is important to have both scientifically rational and cost-effective data on which to base decisions about surgical antimicrobial prophylaxis. In their previous work cited in the Shapiro article, and in other studies, three perioperative doses of cefazolin sodium have been demonstrated in a scientifically rational way to reduce in-hospital infection-related morbidity in patients undergoing vaginal or abdominal hysterectomy. The current article addresses the cost-effective issues concerning such prophylaxis.

What Shapiro et al demonstrate in their article is that the efficacy in cost savings from surgical prophylaxis depends on the following:

  1. 1. The cost of the drug used—cost per dose

REFERENCES

Maki DG, Schuna AA:  A study of antimicrobial misuse in a university hospital . Am J Med Sci 1978;;275:271-282.
Platt R, Polk BF, Murdock B, et al:  Mortality associated with nosocomial urinary-tract infection . N Engl J Med 1982;;307:637-642.
Kleinbaum DG, Morgenstem H, Kupper LL:  Selection bias in epidemiologic studies . Am J Epidemiol 1981;;113:452-463.
Maki DG:  Nosocomial bacteremia, an epidemiologic overview , in Dixon RE (ed): Nosocomial Infections . New York, Yorke Medical Books, 1981;, pp 183-196.
Scheckler WE:  Hospital costs of nosocomial infections: A prospective three-month study in a community hospital . Infection Control 1980;;1:150-152.

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Maki DG, Schuna AA:  A study of antimicrobial misuse in a university hospital . Am J Med Sci 1978;;275:271-282.
Platt R, Polk BF, Murdock B, et al:  Mortality associated with nosocomial urinary-tract infection . N Engl J Med 1982;;307:637-642.
Kleinbaum DG, Morgenstem H, Kupper LL:  Selection bias in epidemiologic studies . Am J Epidemiol 1981;;113:452-463.
Maki DG:  Nosocomial bacteremia, an epidemiologic overview , in Dixon RE (ed): Nosocomial Infections . New York, Yorke Medical Books, 1981;, pp 183-196.
Scheckler WE:  Hospital costs of nosocomial infections: A prospective three-month study in a community hospital . Infection Control 1980;;1:150-152.
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