Evidence map›Paper›PMID 41820715›Full record

Trial reportPharmacoEconomics2026

Economic Evaluation of the Addition of Vancomycin to Cefazolin Prophylaxis in Patients Undergoing Arthroplasty.

An Tran-Duy, Sarah Asbury, Tim Spelman, David L Paterson, Kirsty L Buising, Catherine McDougall, Michael Solomon, Ross Crawford, Sam Adie, Robert Molnar and 6 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in PharmacoEconomics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

An Tran-Duy *Health Economics and Simulation Modelling Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia. an.tran@unimelb.edu.au.ORCID http://orcid.org/0000-0003-0224-2858
Sarah AsburyDepartment of Infectious Diseases, Bayside Health, Melbourne, VIC, Australia.
Tim SpelmanDepartment of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
David L PatersonADVANCE-ID, Saw Swee Hock School for Public Health, National University of Singapore, Singapore, Singapore.
Kirsty L BuisingRoyal Melbourne Hospital, Melbourne, VIC, Australia.
Catherine McDougallUniversity of Queensland and Prince Charles Hospital, Brisbane, QLD, Australia.
Michael SolomonPrince of Wales Hospital, Randwick, Sydney, NSW, Australia.
Ross CrawfordDepartment of Orthopaedics, The Prince Charles Hospital, Metro North Hospital and Health Service, Brisbane, QLD, Australia.
Sam AdieSchool of Clinical Medicine, St. George and Sutherland Clinical Campuses, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia.
Robert MolnarSt George & Sutherland Clinical Campuses, School of Clinical Medicine, University of New South Wales Medicine & Health, Sydney, Australia.
Johnthan MulfordDepartment of Orthopaedics, Launceston General Hospital, Tasmanian Health Service, Launceston, TAS, Australia.
Tiffany Harris-BrownClinical Trials Centre, University of Queensland, Brisbane, QLD, Australia.
Janine RoneyDepartment of Infectious Diseases, Bayside Health, Melbourne, VIC, Australia.
Richard de Steiger *Department of Surgery, Epworth Healthcare, University of Melbourne, Melbourne, VIC, Australia.
Trisha N Peel *Department of Infectious Diseases, Bayside Health, Melbourne, VIC, Australia.
ASAP Trial Group

Funding

National Health and Medical Research Council APP1120331
6 · The paper itself

Abstract

introductionThe addition of a glycopeptide antimicrobial to cephalosporin therapy has been reportedly adopted in practice to prevent surgical site infections (SSIs). We conducted an economic evaluation from the healthcare sector perspective to assess the cost-effectiveness of adding vancomycin to cefazolin prophylaxis in patients undergoing arthroplasty.

methodsData were collected over 180 days in a randomised controlled trial conducted at 11 hospitals in Australia, involving 2044 patients assigned to vancomycin and 2069 to placebo, both in addition to cefazolin. Health utilities were measured using EQ-5D-3L at baseline and 30 days, 90 days, and 180 days post-surgery. Healthcare costs (Australian dollars [AU$]; 2022 values) were estimated using Medicare claim data and hospital administrative records. Bootstrap was used to estimate means and 95% confidence intervals (CIs) of healthcare costs and quality-adjusted life years (QALYs). The net monetary benefit framework was used to construct a cost-effectiveness acceptability curve.

resultsOver 180 days, 96 SSIs occurred in the vancomycin group, and 79 in the placebo group. Mean QALYs were 0.392 (95% CI 0.389-0.395) in the vancomycin group and 0.394 (95% CI 0.391-0.397) in the placebo group. Mean total healthcare costs were AU$5184 (95% CI 4926-5480) in the vancomycin group and AU$5018 (95% CI 4772-5293) in the placebo group. Using willingness-to-pay and willingness-to-accept thresholds from AU$0 to AU$3,000,000, the probability of vancomycin being not cost-effective ranged from 0.79 to 0.87.

conclusionsAdding vancomycin to cephazolin prophylaxis in arthroplasty is most likely not cost-effective. Omitting vancomycin could lead to substantial annual savings for the healthcare sector without compromising health outcomes.

Indexed as

Anti-Bacterial AgentsAntibiotic ProphylaxisArthroplastyCefazolinSurgical Wound InfectionVancomycinAgedAustraliaCost-Benefit AnalysisCost-Effectiveness AnalysisDrug Therapy, CombinationFemaleFirst Generation CephalosporinsHealth Care CostsHumansMaleAnti-Bacterial AgentsCefazolinFirst Generation CephalosporinsVancomycin

Identifiers

PMID41820715
PMCPMC13290946

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.