Cost-effective prophylaxis of surgical infections.

There are few formal pharmacoeconomic studies of antibacterial prophylaxis in surgery. An important reason for this is that such prophylaxis is difficult to study, because extremely large patient samples are needed to demonstrate differences or equalities with reasonable statistical power. When the cost effectiveness of various regimens is evaluated, indirect methods must often be used. Clearly, the ideal prophylactic regimen, both clinically and economically, is one that is easy to administer, has a low acquisition cost, can be given as a single dose and provides maximal protection against postoperative infections. However, if and when such a regimen is identified, its universal acceptance and use might have negative ecological consequences (e.g. the selection of resistant organisms in the hospital environment). Thus, the search for the ideal prophylactic regimen must be a continuous process.