RICHARD K. TOMPKINS, M.D.; DANIEL C. BURNES, M.D.; WILLIAM E. CABLE, B.S.
The cost-effectiveness of preventing primary acute rheumatic fever attacks by oral or benzathine penicillin treatment was analyzed for both epidemic and endemic streptococcal pharyngitis situations. Decision analysis was used: the probabilities and the outcome values were calculated from published data. Three penicillin strategies were compared: (A) treating only patients with group A streptococci-positive throat cultures; (B) treating all patients; (C) treating none of the patients. In the epidemic situation it is medically most effective and least costly to treat all patients with penicillin (Strategy B). In the endemic situation, Strategy B is also most cost-effective when oral penicillin is used in patient populations where the positive throat culture yield is at least 20%. Strategy A is optimal when the yield is between 5% and 20%; below a 5% yield, Strategy C is appropriate. For any individual patient, it is possible that choice of the most cost-effective treatment strategy could be based on the patient's clinical findings.
TOMPKINS RK, BURNES DC, CABLE WE. An Analysis of the Cost-Effectiveness of Pharyngitis Management and Acute Rheumatic Fever Prevention. Ann Intern Med. ;86:481–492. doi: 10.7326/0003-4819-86-4-481
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Published: Ann Intern Med. 1977;86(4):481-492.
Infectious Disease, Rheumatology, Streptococcal Infections.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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