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Antibiotic prophylaxis in the surgical management of miscarriage in low-income countries: A cost-effectiveness analysis of the AIMS trial

The Lancet Global Health Aug 15, 2019

Goranitis I, Lissauer DM, Coomarasamy A, et al. - Through an incremental cost-effectiveness analysis of data from 3,412 women involved to the AIMS trial, a randomized, double-blind, placebo-controlled trial, researchers examined the cost-efficiency of antibiotic prophylaxis in the surgical management of miscarriage in low-income countries. A total of 158 of 3,412 women developed a pelvic infection within 2 weeks of surgery, of which 68 and 90 were in the antibiotic prophylaxis group and in the placebo group, respectively. There was a 97–98% likelihood that antibiotic prophylaxis was a cost-efficient intervention at expected thresholds of willingness-to-pay per additional pelvic infection avoided. The antibiotic prophylaxis group vs the placebo group was US$0·27 less expensive per woman, in terms of postsurgery antibiotics. If implemented routinely prior to the miscarriage surgery, antibiotic prophylaxis could translate to an annual total cost saving of up to $1·4 million and $8·5 million across the four participating countries and across the two regions of sub-Saharan Africa and South Asia, respectively. Hence, antibiotic prophylaxis vs no antibiotic prophylaxis was concluded as more efficient and less expensive. Policymakers in different settings should be certain that antibiotic prophylaxis in miscarriage surgery was cost-effective.
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