Staphylococcus aureus bacteremia: the cost-effectiveness of long-term therapy associated with infectious diseases consultation.
OBJECTIVE
To investigate the cost-effectiveness of long-term therapy for Staphylococcus aureus bacteremia and to determine if an infectious diseases consultation affected the duration of therapy.


METHODS
A decision analysis was performed based on data from the literature. To determine if consultation was related to therapy duration, a retrospective cohort study was performed using tightly matched pairs.


RESULTS
The excess cost per life saved by long-term antibiotics was $500,000. The excess cost per life-year saved was $18,000. Nine pairs were matched. Patients who received consultation were more likely to receive long-term therapy than controls (median 41 days vs 15 days for controls, P = .04).


CONCLUSIONS
The estimated cost per life-year saved by long-term therapy was similar to other accepted medical interventions. Infectious diseases consultation can encourage prolonged duration of antibiotic therapy for S aureus bacteremia.
Lundberg
J
J
Virginia Commonwealth University, Medical College of Virginia, Richmond 23298, USA.
Nettleman
M D
MD
Costigan
M
M
Bentler
S
S
Dawson
J
J
Wenzel
R P
RP
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics*; D016470:Bacteremia / Q000188:drug therapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D016527:Drug Costs; D005260:Female; D006746:Hospital Bed Capacity, 500 and over; D006784:Hospitals, Teaching / Q000191:economics; D006801:Humans; D007484:Iowa; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000191:economics*; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000191:economics* / Q000401:mortality; D013211:Staphylococcus aureus; D013997:Time Factors; D016896:Treatment Outcome; D026712:Value of Life