The large, international, randomized controlled NeoPInS trial showed that procalcitonin (PCT)-guided decision making was superior to standard care in reducing the duration of antibiotic therapy and hospitalization in neonates suspected of early-onset sepsis (EOS), without increased adverse events. This study aimed to perform a cost-minimization study of the NeoPInS trial, comparing health care costs of standard care and PCT-guided decision making based on the NeoPInS algorithm, and to analyze subgroups based on country, risk category and gestational age. Data from the NeoPInS trial in neonates born after 34 weeks of gestational age with suspected EOS in the first 72 h of life requiring antibiotic therapy were used. We performed a cost-minimization study of health care costs, comparing standard care to PCT-guided decision making. In total, 1489 neonates were included in the study, of which 754 were treated according to PCT-guided decision making and 735 received standard care. Mean health care costs of PCT-guided decision making were not significantly different from costs of standard care (€3649 vs. €3616). Considering subgroups, we found a significant reduction in health care costs of PCT-guided decision making for risk category ‘infection unlikely’ and for gestational age ≥ 37 weeks in the Netherlands, Switzerland and the Czech Republic, and for gestational age < 37 weeks in the Czech Republic. Health care costs of PCT-guided decision making of term and late-preterm neonates with suspected EOS are not significantly different from costs of standard care. Significant cost reduction was found for risk category ‘infection unlikely,’ and is affected by both the price of PCT-testing and (prolonged) hospitalization due to SAEs.

中文翻译：

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降钙素原指导决策对新生儿疑似早发性败血症抗生素治疗持续时间的成本影响

大型国际随机对照 NeoPInS 试验表明，降钙素原 (PCT) 指导的决策在减少疑似早发性败血症 (EOS) 新生儿的抗生素治疗持续时间和住院时间方面优于标准护理，且不会增加不良事件。本研究旨在对 NeoPInS 试验进行成本最小化研究，比较标准护理和基于 NeoPInS 算法的 PCT 指导决策的医疗保健成本，并根据国家、风险类别和胎龄分析亚组。使用 NeoPInS 试验的数据，该试验在 34 周胎龄后出生且在生命的前 72 小时内疑似 EOS 需要抗生素治疗的新生儿中使用。我们对医疗保健成本进行了成本最小化研究，将标准护理与 PCT 指导的决策进行了比较。总共，该研究包括 1489 名新生儿，其中 754 名根据 PCT 指导的决策进行治疗，735 名接受标准护理。PCT 指导决策的平均医疗保健成本与标准医疗成本没有显着差异（3649 欧元与 3616 欧元）。考虑到亚组，我们发现在荷兰、瑞士和捷克共和国针对“不太可能感染”风险类别和孕龄≥37 周以及孕龄 < 37 周的 PCT 指导决策的医疗保健成本显着降低捷克共和国。PCT 指导下的疑似 EOS 足月和晚期早产新生儿的医疗保健成本与标准护理成本没有显着差异。发现风险类别“不太可能感染，