ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Economic Evaluations of New Antibiotics: The High Potential Value of Reducing Healthcare Transmission Through Decolonization.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- The neglected model validation of antimicrobial resistance transmission models - a systematic review.Antimicrobial resistance and infection control · 2025Pooled it
- Projected impact of a pathogen reduction intervention on carbapenem-resistant Enterobacterales bloodstream infections and deaths in the United States.Infection control and hospital epidemiology · 2026Article
- Transmission thresholds for the spread of infections in healthcare facilities.PLoS computational biology · 2025Article
- "Dusting Off the Cobwebs": Rethinking How We Use New Antibiotics.Antibiotics (Basel, Switzerland) · 2025Review
- A Theoretical Framework to Quantify the Tradeoff Between Individual and Population Benefits of Expanded Antibiotic Use.Bulletin of mathematical biology · 2025Article
- Expanding the use of mathematical modeling in healthcare epidemiology and infection prevention and control.Infection control and hospital epidemiology · 2024Review
- Decolonization and Pathogen Reduction Approaches to Prevent Antimicrobial Resistance and Healthcare-Associated Infections.Emerging infectious diseases · 2024Review
- Transmission of gram-negative antibiotic-resistant bacteria following differing exposure to antibiotic-resistance reservoirs in a rural community: a modelling study for bloodstream infections.Scientific reports · 2022Article
- Perspectives on the Ethics of Antibiotic Overuse and on the Implementation of (New) Antibiotics.Infectious diseases and therapy · 2022Article
- Modeling transmission of pathogens in healthcare settings.Current opinion in infectious diseases · 2021Review
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundAntibiotics designed to decolonize carriers of drug-resistant organisms could offer substantial population health benefits, particularly if they can help avert outbreaks by interrupting person-to-person transmission chains. However, cost effectiveness of an antibiotic is typically evaluated only according to its benefits to recipients, which can be difficult to demonstrate for carriers of an organism that may not pose an immediate health threat to the carrier.
methodsWe developed a mathematical transmission model to quantify the effects of 2 hypothetical antibiotics targeting carbapenem-resistant Enterobacteriaceae (CRE) among long-term acute care hospital inpatients: one assumed to decrease the death rate of patients with CRE bloodstream infections (BSIs) and the other assumed to decolonize CRE carriers after clinical detection. We quantified the effect of each antibiotic on the number of BSIs and deaths among patients receiving the drug (direct effect) and among all patients (direct and indirect effect) compared to usual care. We applied these results to a cost-effectiveness analysis with effectiveness outcome of life-years gained and assumed costs for antibiotic doses and for CRE BSI.
resultsThe decolonizing antibiotic, once indirect effects were included, produced increased relative effectiveness and decreased relative costs compared to both usual care and the BSI treatment antibiotic. In fact, in most scenarios, the decolonizing drug was the dominant treatment strategy (ie, less costly and more effective).
conclusionsAntibiotics that decolonize carriers of drug-resistant organisms can be highly cost-effective when considering indirect benefits within populations vulnerable to outbreaks. Public health could benefit from finding ways to incentivize development of decolonizing antibiotics in the US, where drugs with unclear direct benefits to recipients would pose difficulties in achieving FDA approval and financial benefit to the developer.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.