Staphylococcus Aureus Prevention Strategies in Cardiac Surgery: A Cost-Effectiveness Analysis

The authors, using a decision analysis model, compared the cost-effectiveness (over one year) of three different strategies for preventing Staphylococcus aureus infections in patients undergoing CABG in the U.S.  The three strategies were as follows:

• Universal decolonization with mupirocin, chlorhexidine, and vancomycin in all patients undergoing CABG
• Targeted decolonization with mupirocin, chlorhexidine, and vancomycin only in patients who are S aureus carriers
• No decolonization in any patients

Findings:  Universal decolonization is the most cost-effective strategy in >91% of simulations in this model.  Annually in the US, universal decolonization is predicted to lead to $102 million in cost savings, while targeted decolonization is predicted to lead to $45 million in cost savings.