AN ECONOMIC-ANALYSIS OF NORFLOXACIN PROPHYLAXIS AGAINST SPONTANEOUS BACTERIAL PERITONITIS

Background/Aims/Methods: Spontaneous bacterial peritonitis (SBP) is a frequent complication of advanced liver disease and in high-risk patie nts, it is associated with a mean (per episode) mortality of 29% and a mean 1-year mortality of 82%. The 1-year recurrence rate of SBP can b e as high as 30-70%. Selective intestinal decontamination with antibio tic prophylaxis has been shown to significantly reduce the incidence o f recurrent SBP. The aim of this study was to perform an economic anal ysis of norfloxacin prophylaxis to prevent SBP recurrence. Results: Th is analysis showed that norfloxacin prophylaxis in high-risk patients with cirrhosis resulted in USD 4632 savings per patient per year by av oiding SBP and its associated expense. A sensitivity analysis showed t hat the norfloxacin prophylaxis remained cost-saving, even if it resul ted in only a modest reduction in the SBP recurrence rate. Conclusions : Selective gut decontamination with norfloxacin is not only efficacio us in preventing SBP, but can also be cost-saving by avoiding the reso urce utilization associated with its treatment.