The ICER for DAP compared to NAP was 28.84 euros per QALD. DAP compared to NAP was more costly (100.90 vs 97.48 euros) and more effective (27.94 vs. IAP compared to DAP was more costly (109.68 vs 100.90 euros) and similarly effective (27.88 vs 27.94 QALDs). QALD values for the three strategies were very similar. ![]() ![]() ResultsĭAP was the most cost-effective strategy, even when the cost of AMR was included. The analysis was performed from a societal perspective for a time horizon of 30 days, and included healthcare direct costs, non-healthcare direct and indirect costs, and the antimicrobial resistance (AMR) cost. Net monetary benefit (NMB) was also calculated as a tool for decision making. The main outcome was the incremental cost-effectiveness ratio (ICER), measured in euros per gained quality-adjusted life days (QALDs). Our trial compared cost-effectiveness for DAP, immediate antibiotic prescription (IAP), and no antibiotic prescription (NAP) for children aged 2–14 years with acute uncomplicated RTIs attended to in 39 primary care centres in Spain. While studies have evaluated DAP efficacy and safety for children with RTIs, little research has been conducted on the economic implications. Delayed antibiotic prescription (DAP) is designed to deploy a more rational use of antibiotics. ![]() Antibiotic prescription for respiratory tract infections (RTIs) in children attending primary care centres is almost double that predicted according to bacterial prevalence.
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