Diagnostic Testing for Sepsis: A Systematic Review of Economic Evaluations

• Main Authors: Paula Rojas-Garcia (Author), Simon van der Pol (Author), Antoinette D. I. van Asselt (Author), Maarten J. Postma (Author), Roberto Rodríguez-Ibeas (Author), Carmelo A. Juárez-Castelló (Author), Marino González (Author), Fernando Antoñanzas (Author)
• Format: Book
• Published: MDPI AG, 2021-12-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.3390/antibiotics11010027; 2079-6382
• Keywords: sepsis; antibiotics; diagnostic testing; AMR; systematic review; Therapeutics. Pharmacology; RM1-950
• Source: Antibiotics, Vol 11, Iss 1, p 27 (2021)

Introduction: Sepsis is a serious and expensive healthcare problem, when caused by a multidrug-resistant (MDR) bacteria mortality and costs increase. A reduction in the time until the start of treatment improves clinical results. The objective is to perform a systematic review of economic evaluations to analyze the cost-effectiveness of diagnostic methods in sepsis and to draw lessons on the methods used to incorporate antimicrobial resistance (AMR) in these studies. Material and Methods: the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the Consolidated Health Economic Evaluation Reporting standards (CHEERS) checklist was used to extract the information from the texts. Results: A total of 16 articles were found. A decision model was performed in 14. We found two ways to handle resistance while modelling: the test could identify infections caused by a resistant pathogen or resistance-related inputs, or outcomes were included (the incidence of AMR in sepsis patients, antibiotic use, and infection caused by resistant bacterial pathogens). Conclusion: Using a diagnostic technique to detect sepsis early on is more cost-effective than standard care. Setting a direct relationship between the implementation of a testing strategy and the reduction of AMR cases, we made several assumptions about the efficacy of antibiotics and the length-of-stay of patients.