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Routine antibiotics benefit elective C-sections. (Study: $2.6 Million Annual Cost Savings).
SAN FRANCISCO -- Routinely giving prophylactic antibiotics to women undergoing uncomplicated elective cesarean deliveries could prevent 25,000 cases of endometritis and wound infections each year in the United States and save $2.6 million in medical costs, Dr. Ian A. Grable said.
His computer model of the costs of care during elective C-sections showed that the net costs through 6 weeks' post partum totaled $1,577 per C-section with antibiotic prophylaxis and $1,628 per case without routine antibiotics.
Prophylaxis would lower the overall infection rate from 13% to 8%, further enhancing its cost-effectiveness, he reported at the annual meeting of the Society for Maternal-Fetal Medicine.
Although intravenous prophylactic antibiotics are the standard of care in non-elective C-sections, where they have been proven cost-effective in reducing infectious morbidity, their use in elective C-sections is controversial. Many clinicians have chosen not to give prophylactic antibiotics in elective C-sections out of concern about both cost and fears of antibiotic resistance, said Dr. Grable of Beth Israel Deaconess Medical Center, Boston.
The current results suggest that more physicians should embrace antibiotic prophylaxis for uncomplicated elective cesarean deliveries "to provide the best and least costly care possible for the most patients," he said.
The study also showed that, for every 1,000 uncomplicated elective C-sections, the overall cost of care without prophylactic antibiotics would be $1.6 million. Prophylaxis would prevent 30 cases of endometritis and 50 cases of infectious morbidity, saving $51,000 overall. Applying those figures to the 500,000 U.S. women who undergo elective C-section each year produces an estimated $2.6 million in savings, said Dr. Grable.
The analysis included only variable costs of medical care, not fixed costs and not societal costs. It could not account for any potential contribution that routine prophylaxis might have to the development of antibiotic resistance among infectious organisms.
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