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A cost-effectiveness comparison of the use of antimicrobial agents for treatment or prophylaxis of travelers' diarrhea.
Arch Intern Med 1988; 148(11):2421-7AI

Abstract

We conducted a decision analysis to compare the cost-effectiveness of antimicrobial agents used for treatment with their use for prophylaxis of travelers' diarrhea. Estimates of the likelihood and the cost of various outcomes were obtained from a panel of experts using the Delphi group opinion technique. Treatment with sulfamethoxazole-trimethoprim for three days was compared with daily prophylaxis with sulfamethoxazole-trimethoprim or doxycycline. The cost-effectiveness of prophylaxis with either agent (75% to 83%) was greater than that of treatment (38%). Treatment would become more cost-effective than prophylaxis when the cumulative risk of acquiring travelers' diarrhea was less than 0.05 episodes per person per week or if the effectiveness of prophylaxis fell below 35% for doxycycline and 46% for sulfamethoxazole-trimethoprim. The most important contributor to the mean cost of travelers' diarrhea in this analysis was the cost associated with a day of incapacitation due to illness. On the basis of the results of this decision analysis, we conclude that prophylaxis of travelers' diarrhea is an option that should be considered for individual situations and recommend further studies of its cost-effectiveness.

Authors+Show Affiliations

Department of Medicine, University of Texas Medical School Program in Infectious Diseases and Clinical Microbiology, Houston 77030.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

3142381

Citation

Reves, R R., et al. "A Cost-effectiveness Comparison of the Use of Antimicrobial Agents for Treatment or Prophylaxis of Travelers' Diarrhea." Archives of Internal Medicine, vol. 148, no. 11, 1988, pp. 2421-7.
Reves RR, Johnson PC, Ericsson CD, et al. A cost-effectiveness comparison of the use of antimicrobial agents for treatment or prophylaxis of travelers' diarrhea. Arch Intern Med. 1988;148(11):2421-7.
Reves, R. R., Johnson, P. C., Ericsson, C. D., & DuPont, H. L. (1988). A cost-effectiveness comparison of the use of antimicrobial agents for treatment or prophylaxis of travelers' diarrhea. Archives of Internal Medicine, 148(11), pp. 2421-7.
Reves RR, et al. A Cost-effectiveness Comparison of the Use of Antimicrobial Agents for Treatment or Prophylaxis of Travelers' Diarrhea. Arch Intern Med. 1988;148(11):2421-7. PubMed PMID: 3142381.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A cost-effectiveness comparison of the use of antimicrobial agents for treatment or prophylaxis of travelers' diarrhea. AU - Reves,R R, AU - Johnson,P C, AU - Ericsson,C D, AU - DuPont,H L, PY - 1988/11/1/pubmed PY - 1988/11/1/medline PY - 1988/11/1/entrez SP - 2421 EP - 7 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 148 IS - 11 N2 - We conducted a decision analysis to compare the cost-effectiveness of antimicrobial agents used for treatment with their use for prophylaxis of travelers' diarrhea. Estimates of the likelihood and the cost of various outcomes were obtained from a panel of experts using the Delphi group opinion technique. Treatment with sulfamethoxazole-trimethoprim for three days was compared with daily prophylaxis with sulfamethoxazole-trimethoprim or doxycycline. The cost-effectiveness of prophylaxis with either agent (75% to 83%) was greater than that of treatment (38%). Treatment would become more cost-effective than prophylaxis when the cumulative risk of acquiring travelers' diarrhea was less than 0.05 episodes per person per week or if the effectiveness of prophylaxis fell below 35% for doxycycline and 46% for sulfamethoxazole-trimethoprim. The most important contributor to the mean cost of travelers' diarrhea in this analysis was the cost associated with a day of incapacitation due to illness. On the basis of the results of this decision analysis, we conclude that prophylaxis of travelers' diarrhea is an option that should be considered for individual situations and recommend further studies of its cost-effectiveness. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/3142381/A_cost_effectiveness_comparison_of_the_use_of_antimicrobial_agents_for_treatment_or_prophylaxis_of_travelers'_diarrhea_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/vol/148/pg/2421 DB - PRIME DP - Unbound Medicine ER -