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Objective: Antibiotic-associated diarrhea (AAD) is a common complication of systemic antibiotic treatment. AAD is associated with extra investigations and treatment and additional nursing care, thus leading to higher costs. Lactobacillus rhamnosus GG (LGG) is a probiotic that has been showing to reduce the risk of AAD in children. The objective of this study is to evaluate the cost-effectiveness of LGG for preventing AAD in children in Colombia, from private hospital’s perspective. Methods: It was developed a decision tree using Microsoft Excel to simulate the clinical course of a patient in antibiotic treatment. The population assessed was pediatric patients receiving antibiotic therapy during hospitalization. The data on efficacy, effectiveness, use of resources, and costs were obtained from literature review. It was considered the cost of one sachet as 4,947.97 Colombian pesos (COP), obtained from Colombian drugstore websites. In the model, it was used a duration of two days minimum AAD for both LGG and placebo arms. Only direct expenses were considered to estimate the cost of treatment with LGG compared with placebo. A deterministic sensitivity analysis was performed to measure the robustness of the model. Results: In the base case scenario, the use of LGG for treating AAD in pediatric patients was less costly when compared with placebo or no additional intervention: 45,820.11 COP versus 76,093.97 COP, respectively, representing a dominating incremental cost-effectiveness ratio (ICER) of -225,924.37 COP/AAD avoided. The deterministic sensitivity analysis showed that the main costs were the length of hospital stay with placebo or no additional prophylactic therapy, the length of hospital stay with LGG prophylactic therapy, and the duration of antibiotic therapy. Conclusion: Based on a Colombian private hospital’s perspective, the use of LGG as prophylactic therapy for AAD in pediatric inpatients, during antibiotic therapy, was more effective and less costly compared with placebo or no additional intervention.

Cost-Effectiveness of Lactobacillus rhamnosus GG on the Prevention of Antibiotic-Associated Diarrhea in Children in Colombia