Cost effectiveness of management strategies for urinary tract infections: results from randomised controlled trial

摘要: Objective To assess the cost effectiveness of different management strategies for urinary tract infections. Design Cost analysis alongside a randomised controlled trial with one month follow-up. Setting Primary care. Participants 309 non-pregnant adult women aged 18-70 presenting suspected infection. Interventions Patients were to five basic approaches: empirical antibiotics, delayed (by 48 hours) or targeted antibiotics based on either high symptom score (two more urine cloudiness, smell, nocturia, dysuria), dipstick results (nitrite leucocytes and blood), receipt positive result midstream analysis. Main outcome measure Duration symptoms Results Management was costly over period month. Costs groups £37 £35, respectively; these compared £31 immediate antibiotics. acceptability curves suggested that if avoiding day moderately bad valued at less than £10, then is likely be most effective strategy. For values testing becomes strategy, though because uncertainty we can never 70% certain this strategy truly effective. Conclusion Dipstick value saving £10 more, but caution required given considerable surrounding estimates.