title: Cost effectiveness of antimicrobial catheters for adults requiring short-term catheterisation in hospital.
abstract: Catheter-associated urinary tract infection (CAUTI) is the second most common cause of hospital-acquired infection. A number of strategies have been put forward to prevent CAUTI, including the use of antimicrobial catheters. We aimed to assess whether the use of either a nitrofurazone-impregnated or a silver alloy-coated catheter was cost-effective compared with standard polytetrafluoroethylene (PTFE)-coated catheters. A decision-analytic model using data from a clinical trial conducted in the United Kingdom was used to calculate the incremental cost per quality-adjusted life-year (QALY). We assumed that differences in costs and QALYs were driven by difference in risk of acquiring a CAUTI. Routine use of nitrofurazone-impregnated catheters was, on average, £7 (€9) less costly than use of the standard catheter over 6 wk. There was a >70% chance that use of nitrofurazone catheters would be cost saving and an 84% chance that the incremental cost per QALY would be less than £30 000 (€36 851; a commonly used threshold for society's willingness to pay). Silver alloy-coated catheters were very unlikely to be cost-effective. The model's prediction, although associated with uncertainty, was that nitrofurazone-impregnated catheters may be cost-effective in the UK National Health System or a similar setting.
authors: Health Economics Research Unit, University of Aberdeen, Aberdeen, UK. Electronic address: m.kilonzo@abdn.ac.uk.
authors: Mary
authors: M
authors: Kilonzo
authors: Health Economics Group, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors: Luke
authors: L
authors: Vale
authors: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
authors: Robert
authors: R
authors: Pickard
authors: Academic Urology Unit, University of Aberdeen, Aberdeen, UK.
authors: Thomas
authors: T
authors: Lam
authors: Academic Urology Unit, University of Aberdeen, Aberdeen, UK.
authors: James
authors: J
authors: N'Dow
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000494:pharmacology*; D055499:Catheter-Related Infections / Q000191:economics / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000209:etiology / Q000517:prevention & control*; D017721:Hospital Costs; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay / Q000191:economics; D009583:Nitrofurazone / Q000494:pharmacology; D019057:Quality-Adjusted Life Years; D012307:Risk Factors; D018030:Silver Compounds / Q000494:pharmacology; D013997:Time Factors; D006113:United Kingdom; D014546:Urinary Catheterization / Q000009:adverse effects* / Q000379:methods; D062885:Urinary Catheters / Q000191:economics / Q000639:trends
chemical_list: D000890:Anti-Infective Agents; D018030:Silver Compounds; D009583:Nitrofurazone
keywords: Antimicrobial catheters; Catheter-associated symptomatic urinary tract infection; Cost effectiveness; Costs; Decision-analytic model; Randomised controlled trial