Cost-effectiveness of Combined Treatment for Endocervical Gonorrhea
Considering Co-infection With Chlamydia trachomatis
- A. Eugene Washington, MD, MSc;
- Warren S. Browner, MD, MPH;
- Carol C. Korenbrot, PhD
- From the Division of Sexually Transmitted Diseases, Center for Prevention Services, Centers for Disease Control, Atlanta (Dr Washington); the Division of General Internal Medicine, Veterans Administration Medical Center, San Francisco (Dr Browner); and the Center for Population and Reproductive Health Policy (Dr Korenbrot) and Clinical Epidemiology Program (Drs Browner and Washington), Institute for Health Policy Studies, University of California School of Medicine, San Francisco. Dr Washington is now with Stanford (Calif) University School of Medicine.
Abstract
Three treatment regimens are currently recommended for penicillin-susceptible Neisseria gonorrhoeae infection of the cervix: ampicillin, tetracycline, and a combination of ampicillin and tetracycline. To evaluate the cost-effectiveness of these options, we developed a decision analysis model and analyzed the efficacy of each treatment in curing gonorrhea, as well as coexisting Chlamydia trachomatis infection, and in preventing subsequent pelvic inflammatory disease, ectopic pregnancy, and infertility. We included direct costs of medication and expenditures for management of unresolved infections and associated complications. Combination treatment is more than twice as cost-effective as tetracycline and seven times as cost-effective as ampicillin when the medical cost of managing pelvic inflammatory disease is considered. When the costs of ectopic pregnancies and infertility are included, the cost-effectiveness of combination treatment increases further.
(JAMA 1987;257:2056-2060)
Footnotes
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Reprint requests to Technical Information Services, Center for Prevention Services, Centers for Disease Control, Atlanta, GA 30333 (Dr Washington).
