Cost-effectiveness decision analysis of intramuscular ceftriaxone versus oral cefixime in adolescents with gonococcal cervicitis

Annals of Emergency Medicine
L R FriedlandA Patterson

Abstract

We compared the cost-effectiveness of two single-dose treatment strategies for adolescents with uncomplicated Neisseria gonorrhoeae cervicitis. We used a cost-effectiveness decision- analysis model to compare the two methods: the standard, ceftriaxone 125 mg given by IM injection; and an alternative, cefixime 400 mg given orally. The effect of the costs associated with the risk of accidental needlestick during IM administration was also evaluated. Key baseline assumptions (with ranges, when tested) were from the literature or costs to our hospital. These included ceftriaxone, $8.60 per dose; cefixime, $4.67 per dose; ceftriaxone efficacy, 98% (range, 94.9% to 100%); cefixime efficacy, 97% (94.1% to 100%); and a 15% probability of pelvic inflammatory disease (PID) related to failed treatment. We included costs for PID necessitating hospitalization, disseminated gonococcal infection, infertility, and ectopic pregnancy. Assumptions related to accidental needlestick included the rate of needlesticks with the disposable syringe, 6.9 per 100,000 injections (range, 0 to 69); cost of accidental needlestick to hospital; risk of HIV seroconversion after needlestick exposure to HIV-infected blood, .36% (range, 0% to .86%); rate of HIV inf...Continue Reading

References

Mar 1, 1975·American Journal of Obstetrics and Gynecology·L Weström
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Jul 28, 1993·JAMA : the Journal of the American Medical Association·F J Hellinger

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Citations

Jun 25, 2005·Sexually Transmitted Diseases·Julia E AledortSue J Goldie
Jun 15, 2007·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Emily M O'MalleyAdelisa L Panlilio
Jul 13, 2005·British Journal of Nursing : BJN·Mandy Tyson
Aug 6, 1999·FEMS Immunology and Medical Microbiology·A Bulut

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