MP11-01 DAILY VERSUS POSTCOITAL ANTIBIOTIC PROPHYLAXIS IN WOMEN WITH RECURRENT URINARY TRACT INFECTIONS: CHOICE OF ANTIBIOTIC FROM A COST-EFFECTIVENESS PERSPECTIVE
Bibliographic record
Abstract
You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness II1 Apr 2014MP11-01 DAILY VERSUS POSTCOITAL ANTIBIOTIC PROPHYLAXIS IN WOMEN WITH RECURRENT URINARY TRACT INFECTIONS: CHOICE OF ANTIBIOTIC FROM A COST-EFFECTIVENESS PERSPECTIVE Hin Yu Vincent Tu and Timothy Davies Hin Yu Vincent TuHin Yu Vincent Tu More articles by this author and Timothy DaviesTimothy Davies More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.416AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Increasing evidence suggests that daily or postcoital antibiotic prophylaxis are effective strategies in the management of women with recurrent urinary tract infections (UTI). The purpose of our study is to compare the cost-effectiveness of different antibiotics used for daily and postcoital prophylaxis. METHODS A decision analysis model was developed to estimate the costs of daily and postcoital antibiotic prophylaxis in the reduction of UTIs per patient year. Prophylaxis success was defined as less than one microbacterial recurrence per patient year (MRPY). Our model was populated using data obtained from the EAU review and the Cochrane Review (CR) on UTIs. Antibiotics used for daily prophylaxis included: trimethoprim, nitrofurantoin, cephalexin and ciprofloxacin. Trimethoprim-sulfamethoxazole (TMP-SMZ) and ciprofloxacin were included as postcoital antibiotics. Costs were obtained from the Provincial Drug Benefit formulary. Univariate sensitivity analysis was performed to determine the robustness of our model. RESULTS Postcoital antibiotic prophylaxis was more cost-effective than daily prophylaxis at reducing MRPY. When the frequency of sexual intercourse (FSI) was once per week, postcoital TMP-SMZ 40/200mg was the most cost-effective agent, reducing MRPY to less than one at a cost of $1.3 Canadian dollars per patient year (CAD/py). This was followed by postcoital ciprofloxacin 125mg at a cost of $15.2 CAD/py. The cost of daily cephalexin 125mg and daily nitrofurantoin 100mg was $22.5 CAD/py and $41.5 CAD/py respectively. Sensitivity analyses suggested that as the FSI increased beyond 1.4 times per week, postcoital TMP-SMZ remained the most cost-effective however postcoital ciprofloxacin became less cost-effective than daily cephalexin prophylaxis. CONCLUSIONS In the management of recurrent UTIs, prophylactic postcoital antibiotics is the most cost-effective solution. Our study suggests that postcoital TMP-SMZ should be the initial antibiotic choice. This is followed by postcoital ciprofloxacin if the FSI is less than once per week, and daily cephalexin if the FSI is greater than twice per week. Decisions for antibiotic choice should also be made in conjunction with local resistance patterns and clinical judgement. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e95 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Hin Yu Vincent Tu More articles by this author Timothy Davies More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.022 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.004 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".