Table 5.
The base-case scenario for generic antimicrobials compared with the combination of blood culture monitoring and evidence-based antimicrobials (southern Africa and west and central Africa)
| Measure | Southern Africa | West and central Africa | ||
|---|---|---|---|---|
| Generic antimicrobials | Blood culture monitoring + evidence-based antimicrobials | Generic antimicrobials | Blood culture monitoring + evidence-based antimicrobials | |
| (Column number) | (1) | (2) | (3) | (4) |
| Probability antimicrobials appropriate | 0.24 | 0.62 | 0.22 | 0.56 |
| Probability mortality if antimicrobials appropriate | 0.20 | 0.20 | 0.20 | 0.20 |
| Probability mortality if antimicrobials inappropriate | 0.50 | 0.50 | 0.50 | 0.50 |
| Probability patient lives | 0.94 | 0.95 | 0.94 | 0.95 |
| Expected cost per patient, $ | 6.84 | 32.19 | 6.84 | 32.19 |
| Deaths per 100,000 patients | 5,899 | 4,631 | 5,966 | 4,832 |
| Difference in survival | – | 1,268 | – | 1,134 |
| Difference in expected cost per patient, $ | – | 25.35 | – | 25.35 |
| ICER, $ | – | 2,000 | – | 2,235 |
ICER = incremental cost-effectiveness ratio.
Values in parentheses refer to columns as cited in text. For all scenarios, the prevalence of sepsis is 0.134. Sensitivity of clinical assessment is set at 0.83 and specificity at 0.62. The cost of antimicrobials is $13.22 in the generic case and $26.46 in the evidence-based case. In the evidence-based case, there is an additional cost of $11.41 for a negative blood culture test and $71.96 for a positive blood culture test.
Numbers in parentheses refer to columns as cited in text.