OBJECTIVES: to estimate the cost effectiveness of the tests available for the detection of bacterial infections in patients diagnosed with chronic obstructive disease (COPD) and presenting an exacerbation of their pathology that requires attention in the intensive care unit service. Procalcitonin is the intervention and CRP the comparator

METHODS: A literature review was carried out to characterize the correct patient to use antibiotics for each test, additionally, the patient care process for the resolution of their exacerbation was characterized. Subsequently, the information collected was validated with a clinical expert who also defined the procedures and health resources necessary to carry out each test. These resources were assessed and included in a decision tree model that evaluates the performance of each test over a 14-day time horizon. The model considers the length of stay and the use of empirical and specific antibiotic therapy

RESULTS: It was found for the base case that there is a saving of $1,590,761 COP (331.4 USD; 1USD= 4800COP) when using the procalcitonin detection technique instead of PCR. These results are 18% less of antibiotic treatment used compared to the PCR test (no use of antibiotics 56% and 38% respectively), which impacts the added cost with a difference in favor of procalcitonin of $286,337. COP (59.6 UDS). The results of the deterministic sensitivity analysis show that the number of antibiotic days is the only variable that changes the base case results, and the probabilistic analysis shows that 89% of the iterations is dominant, which supports the base case result

CONCLUSIONS: Results were obtained in favor of the test with procalcitonin, the test may be superior to CRP in patients with suspicion of sepsis and is associated with a shorter duration of therapy and improved survival, particularly in RCT without high protocol adherence