Table 6.

The base-case scenario for generic antimicrobials compared with the combination of blood culture monitoring and evidence-based antimicrobials for two hypothetical scenarios

Measure	Hypothetical 1		Hypothetical 2
	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	0.07	0.35	0.25	0.34
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	0.94	0.94	0.94
Expected cost per patient, $	6.84	32.19	6.84	32.19
Deaths per 100,000 patients	6,466	5,532	5,866	5,566
Difference in survival	–	934	–	300
Difference in expected cost per patient, $	–	25.35	–	25.35
ICER, $	–	2,714	–	8,443

ICER = incremental cost-effectiveness ratio.

Hypothetical 1 used the prevalence values for the entire African continent but was reconfigured such that all Salmonella enterica and Streptococcus pneumoniae isolates were resistant to ampicillin. Hypothetical 2 was based on prevalence figures for north Africa and was reconfigured such that the prevalence of Salmonella enterica and Brucella spp. is exchanged. 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.