Cost-effectiveness analysis of 2 g of cefazolin compared with 1 g of cefazolin as prophylactic antibiotics in cesarean section at the Mekong Maternity Hospital from 2021 to 2022

Objective: To investigate the cost-effectiveness of using the prophylactic antibiotic cefazolin during cesarean section with a dose of 2 g compared to 1 g by clinical practice at the Mekong Maternity Hospital. Methods: A cost-effectiveness analysis applying a decision tree was conducted to compare the use of cefazolin 2g to cefazolin 1g from a healthcare sector’s perspective. Cost parameters were extracted and calculated from electronic medical records from the Mekong Maternity Hospital, whereas quality-adjusted life-years were derived through literature review. Hospital data were collected retrospectively from January 2021- June 2021 for women prophylactically using 1g of cefazolin and prospectively from January 2022-June 2022 for those treating with 2 g of cefazolin. The Incremental Cost-effectiveness Ratio was estimated to determine whether it is cost-effective between two regimens. Sensitivity analyses were used to examine the robustness of the results. Main findings: The use of 2 g of cefazolin for prophylactic antibiotics in the cesarean section per each woman was less expensive at 28.353.391 VND compared with 28.410.451 VND for the use of 1 g of cefazolin. Also, it was more effective expressed by higher QALYs at 0,9194 versus 0,9154 in case using 1 g of cefazolin, resulting as the dominant regimen. Cefazolin 2g usage gained a 65.9% probability being more cost-effective than 1 g of cefazolin at the willingness to pay threshold of 3GDP per capita. Conclusion: The use of 2 g of cefazolin was likely to be dominant over 1 g of cefazolin pertaining to cost-effectiveness terms as a cesarean delivery infection prophylaxis. Keywords: Cesarean section; cost-effectiveness analysis; cefazolin; different doses; prophylactic antibiotics