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March 11, 1983

The Cost of Prevention: Common Sense and Decision Trees

Author Affiliations

University of Wisconsin Medical School Madison

JAMA. 1983;249(10):1328. doi:10.1001/jama.1983.03330340070037

In this issue of The Journal (page 1290), Shapiro and colleagues have constructed a promising benefit-cost analysis of surgical antimicrobial prophylaxis. Numerous studies in recent years indicate that 30% to 50% of total in-hospital antibiotic use, especially the cephalosporin group of drugs, is given for prevention of postoperative infection.1 It is important to have both scientifically rational and cost-effective data on which to base decisions about surgical antimicrobial prophylaxis. In their previous work cited in the Shapiro article, and in other studies, three perioperative doses of cefazolin sodium have been demonstrated in a scientifically rational way to reduce in-hospital infection-related morbidity in patients undergoing vaginal or abdominal hysterectomy. The current article addresses the cost-effective issues concerning such prophylaxis.

What Shapiro et al demonstrate in their article is that the efficacy in cost savings from surgical prophylaxis depends on the following:

  1. 1. The cost of the drug used—cost per dose