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This study evaluated the clinical utility and cost effectiveness of traditional MCS studies as decision tools in choosing antibiotics to treat infections in two tertiary hospitals in Northern Nigeria by retrospective evaluation of MCS records over six consecutive months. Of the 942 MCS studies that included 385(40.9%), 296(31.4%), 144 (15.3%) 45 (4.8%) , 40 (4.3%), 26(3.1%) and 6(0.2%) urine, high vaginal swabs (HVS) , stool, sputum, pus, endocervical swabs (ECS) and urethral swabs specimens performed, respectively on 510(54%) males and 432 (46%) females, only 9 (0.6%) had results that offered demonstrable influence on patients’ treatment at a cost effectiveness ratio of 4260.6 International dollars per 1. The estimated cost of MCS studies to the Nigerian economy (public health care provider) was 39.8million International dollars per annum. Our findings suggest that the traditional algorithm for decision on choice of antibiotic is not cost-effective. We proposed that empirical treatment based on community profiling of bacterial sensitivity to antibiotics may be superior.

Cost-effectiveness analysis of microscopy, culture and sensitivity study as a decision tool in choice of antibiotics in clinical practice.