Resumo

CALZADILLA MOREIRA, Vladimir et al. Cost-effectiveness analysis of perioperative prophylaxis with cephalosporin in orthopedic and traumatologic surgery. Rev Cub Med Mil [online]. 2007, vol.36, n.1. ISSN 0138-6557.

The effectiveness of three cephalosporins (Cefazolin, Cefotaxime, and Ceftazidime of first and third generation, respectively), was determined for the prophylaxis of infection in the surgical site, in the Orthopedics and Traumatology Service of “Dr. Luis Díaz Soto” Higher Institute of Military Medicine by the short method (3 doses). A cost-effectiveness analysis was made of each drug, using a longitudinal prospective design with 1 094 patients operated on from October 2001 to December 2003. 344 cases were administered Cefazolin, 354 received Ceftazidime, and Ceftazidime was used in 396. Their effectiveness was measured by its capacity to prevent the postoperative infection. The costs generated by the use of different antimicrobials were estimated. In the three compared groups, the features regarding age and sex were similar. We achieved a protective coverage of 97.1% of the patients included in the series, although without significant differences among them. The group receiving Cefazolin was the most protected (97.6 %). This antibiotic proved to be the lowest average cost alternative , with a total expense of $2 408 for a cost-effectiveness ratio of $ l7.2. The use of third generation cepaholosporins implicates an increase of the costs of 5.3 times for Cefotaxim, and 9.8 times for Ceftazidime. The results of the study demonstrate the economical convenience and the benefits of using Cephalosporins for health. The administration of Cefazolin reported a higher effectiveness.

Palavras-chave : Prophylaxis; cephalosporins; infection; surgical site; costs; effectiveness..