Is Antimicrobial Prophylaxis of Urinary Tract Infections Cost Effective?

  1. WALTER E. STAMM, M.D.;
  2. MARY McKEVITT, R.N.;
  3. GEORGE W. COUNTS, M.D.;
  4. KENNETH F. WAGNER, D.O.;
  5. MARVIN TURCK, M.D.; and
  6. KING K. HOLMES, M.D., Ph.D.
  1. Seattle, Washington

    Abstract

    Antimicrobial prophylaxis prevents recurrent urinary tract infections in susceptible women, but its cost effectiveness has not been studied. In a recent placebo-controlled trial of urinary prophylaxis; we also assessed cost effectiveness using a decision analysis model. In our hospital the direct cost of 1 patient year of urinary prophylaxis approximates the cost of treating one episode of cystitis. In women with a baseline infection rate of three per patient year, the annual cost of prophylaxis ($85.82) was less than treatment of acute episodes of infection ($392.30). Sensitivity analyses showed that in women with three infections per year, prophylaxis became cost effective when charges per episode exceeded $42.00. In women with frequent episodes of cystitis, prophylaxis will be cost effective in most practice settings.

    Article and Author Information

    • ▸From the Division of Infectious Diseases, Department of Medicine, University of Washington School of Medicine; Harborview Medical Center; and the U.S. Public Health Service Hospital; Seattle, Washington.

    • Grant support: in part by Program Grant SEA 76-06-72 from the Division of Hospitals and Clinics, Bureau of Medical Services, U.S. Department of Health and Human Services; Program Project Grant AI-12192 and Training Grant AI-07044 from the National Institutes of Health; and a grant from Burroughs-Wellcome Company.

    • ▸Requests for reprints should be addressed to Walter E. Stamm, M.D.; Harborview Medical Center, 325 Ninth Avenue; Seattle, WA 98104.

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