Cost Analysis of Fluconazole Prophylaxis for Prevention of Neonatal Invasive Candidiasis

The Pediatric Infectious Disease Journal
Jonathan R SwansonRobert A Sinkin

Abstract

Fluconazole prophylaxis (FP) in premature infants is well studied and has been shown to decrease invasive candidiasis (ICs). IC in neonates has significant financial costs; determining the cost-benefit of FP may provide additional justification for targeting high-risk neonates. We aimed to determine the IC rate in premature infants at which FP is cost-beneficial. A decision tree cost-analysis model using cost of FP related to costs associated with IC was used. We searched PubMed for all papers that used intravenous FP and reported rates of IC in very low birth weight neonates. Average IC rates in those who received FP (2.0%; range, 0-6.1%) and in those who did not receive FP (9.2%; range, 0-20.5%) were used. Incremental hospital costs because of IC and for FP were retrieved from the literature. Sensitivity analysis was performed to determine the incremental cost of FP across the range of published IC rates. The average cost per patient attributed to IC in patients receiving FP was $785 versus $2617 in those not receiving FP. Sensitivity analysis demonstrates the rate of IC would need to be <2.8% for FP to lose its cost-benefit. In Monte Carlo simulation, targeting infants <1000 g would lead to $50,304,333 in cost savings per ye...Continue Reading

References

Jan 1, 1988·American Journal of Perinatology·M E SimsF J Walther
Oct 14, 1998·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·B E LeeC M Robertson
Jan 5, 2002·The New England Journal of Medicine·D KaufmanL G Donowitz
Oct 29, 2002·Seminars in Neonatology : SN·William H Edwards
Dec 24, 2004·Journal of Perinatology : Official Journal of the California Perinatal Association·Alan R SpitzerMichael Kornhauser
Jul 16, 2005·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Juliette MorganSteven M Teutsch
Aug 30, 2005·The Journal of Pediatrics·Giovanna BertiniFirmino F Rubaltelli
Jan 7, 2006·Pediatrics·Daniel K BenjaminUNKNOWN National Institute of Child Health and Human Development Neonatal Research Network
Aug 31, 2006·Journal of Perinatology : Official Journal of the California Perinatal Association·Z H AghaiG E Stahl
Apr 5, 2007·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Theoklis E ZaoutisChris Feudtner
Apr 27, 2007·Archives of Disease in Childhood. Fetal and Neonatal Edition·Brian A McCrossanDavid G Sweet
May 9, 2007·The Pediatric Infectious Disease Journal·P Brian SmithDaniel K Benjamin
Jun 15, 2007·The New England Journal of Medicine·Paolo ManzoniUNKNOWN Italian Society of Neonatology
Jan 11, 2008·Journal of Perinatology : Official Journal of the California Perinatal Association·J-H WeitkampA L Potts
May 14, 2008·Current Opinion in Pediatrics·David A Kaufman
Nov 28, 2008·Archives of Disease in Childhood. Fetal and Neonatal Edition·K GanesanC W Yoxall
Mar 27, 2009·Archives of Disease in Childhood. Fetal and Neonatal Edition·A HowellUNKNOWN Australasian Study Group For Neonatal Infections
Nov 26, 2009·The Pediatric Infectious Disease Journal·Mariam AzizJames B McAuley
Jun 24, 2010·The Pediatric Infectious Disease Journal·Kathia RuedaXavier Sáez-Llorens
Sep 30, 2010·Pediatrics·Daniel K BenjaminUNKNOWN Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
Nov 3, 2010·Pediatrics International : Official Journal of the Japan Pediatric Society·Vishwanath BhatZubair H Aghai
Jul 16, 2011·Journal of Perinatology : Official Journal of the California Perinatal Association·A MartinG Natarajan
Sep 14, 2011·European Journal of Pediatrics·Florentia KaguelidouEvelyne Jacqz-Aigrain
Mar 1, 2012·Child: Care, Health and Development·S PetrouN Marlow
May 26, 2012·European Journal of Pediatrics·Asaph RolnitskyGil Klinger
Aug 16, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Angela Ahlquist ClevelandTom M Chiller
Jun 4, 2013·The Journal of Pediatrics·Ira Adams-ChapmanUNKNOWN Eunice Kennedy Shriver National Institutes of Child Health and Human Development Neonatal Research Network
Jan 22, 2014·Pediatrics·Sofia AliagaP Brian Smith
May 6, 2014·JAMA : the Journal of the American Medical Association·Daniel K BenjaminUNKNOWN Fluconazole Prophylaxis Study Team
Mar 1, 2014·Journal of the Pediatric Infectious Diseases Society·Jonathan R SwansonDavid A Kaufman

❮ Previous
Next ❯

Citations

Aug 14, 2018·Hospital Practice·Zeynep Ture, Emine Alp
Mar 22, 2018·The Pediatric Infectious Disease Journal·Joseph Y TingUNKNOWN Canadian Neonatal Network Investigators

❮ Previous
Next ❯

Related Concepts

Related Feeds

Candida albicans

Candida albicans is an opportunistic, fungal pathogen of humans that frequently causes superficial infections of oral and vaginal mucosal surfaces of debilitated and susceptible individuals. Discover the latest research on Candida albicans here.