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Cost-analysis of inpatient and outpatient parenteral antimicrobial therapy in orthopaedics: A systematic literature review

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World Journal of Clinical Cases 2019年第14期7卷 1825-1836页

作者： Christoph Kolja Boese Philipp Lechler michael frink michael Hackl Peer Eysel Christian Ries Department of Orthopaedic and Trauma Surgery University Hospital of CologneCologne 50931Germany Clinic for Trauma and Hand Surgery KreisklinikenAltotting 84503Germany Center for Orthopaedics and Trauma Surgery University Hospital Giessen and MarburgMarburg 35043Germany

BACKGROUND Increasing numbers of total joint arthroplasties and consecutive revision surgery are associated with the risk of periprosthetic joint infections (PPJI). Treatment of PPJI is complex and associated with immense socio-economic burden. One treatment aspect is parenteral antiinfective therapy, which usually requires an inpatient setting [Inpatient parenteral antibiotic therapy (IPAT)]. An alternative is outpatient parenteral treatment [Outpatient parenteral antibiotic therapy (OPAT)]. To conduct a health economic cost-benefit analysis of OPAT, a detailed cost analysis of IPAT and OPAT is required. So far, there is a lack of knowledge on the health economic effects of IPAT and OPAT for PPJI. AIM To review an economic comparison of IPAT and OPAT. METHODS A systematic literature review was performed through Medline following the PRISMA guidelines. RESULTS Of 619 identified studies, 174 included information of interest and 21 studies were included for quantitative analysis of OPAT and IPAT costs. Except for one study, all showed relevant cost savings for OPAT compared to IPAT. Costs for IPAT were between 1.10 to 17.34 times higher than those for OPAT. CONCLUSION There are only few reports on OPAT for PPJI. Detailed analyses to support economic or clinical guidelines are therefore limited. There is good clinical evidence supporting economic benefits of OPAT, but more high quality studies are needed for PPJI.

关键词： Antibiotic therapy Outpatient parenteral antibiotic therapy Inpatient parenteral antibiotic therapy Cost analysis Periprosthetic joint infection Parenteral

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