[Health Economical Evaluation of antibiotic prophylaxis against postoperative endophthalmitis].
BACKGROUND
Two independent epidemiological studies recently suggested the prophylactic relevance of an intraocular antibiosis against endophthalmitis after cataract surgery. The resulting intervention programme, however, has not only ethical drawbacks, but also has a health economical dimension, which will be focussed in this paper.


METHODS
A cost analysis is performed to compare the direct costs saved by prevention of endophthalmitis cases and the costs generated by the prophylaxis itself. Furthermore, the clinics' indirect costs due to treatment of unprevented endophthalmitis cases are estimated.


RESULTS
The overall gain in direct costs turns out to be about 368 000 Euro p. a., the indirect costs from the clinics' view can be reduced by about 260 000 Euro p. a. due to prevention of endophthalmitis cases by the antibiotic intervention.


CONCLUSIONS
From an economical point of view, antibiotic prophylaxis can be suggested; the risk of longitudinally reduced antibiotic effectiveness of the antibiotic agents, however, strongly calls for an overall health political decision rather than for an immediate implementation of the corresponding intervention programme.
Krummenauer
Frank
F
Koordinierungszentrum für Klinische Studien der Universität Mainz,Germany. krummi@imsd.uni-mainz.de
Lehnert
Gangolf
G
Dick
H Burkhard
HB
D019072:Antibiotic Prophylaxis / Q000191:economics*; D002387:Cataract Extraction / Q000191:economics*; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D004351:Drug Resistance; D009877:Endophthalmitis / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control; D005839:Gentamicins / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics*; D005858:Germany; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D009313:National Health Programs / Q000191:economics; D011183:Postoperative Complications / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control; D018570:Risk Assessment
D005839:Gentamicins