亚胺培南抗外科术后感染的给药方案结合蒙特卡洛模拟的药物经济学评价  

Pharmacoeconomic evaluation of imipenem for anti-postoperative infection based on Monte Carlo simulation

作　　者：陈欣[1] 徐雅晶[1] 李英[1] 王莉[1] 冯婉玉[1] 

机构地区：[1]北京大学人民医院药剂科,北京100044

出　　处：《中国新药杂志》2013年第6期691-694,708,共5页Chinese Journal of New Drugs

摘　　要：目的:探讨亚胺培南的不同给药方案应用于外科术后抗感染治疗的经济效果。方法:调查筛选我院2009-2010年普外科术后应用亚胺培南抗感染的病例共119例,按照实际用药方案分为0.5 g,bid;0.5 g,tid;0.5 g,qid;1.0 g,bid;1.0 g,tid共5组,分别进行蒙特卡洛模拟(MCS),计算各方案的累积反应分数(CFR),运用药物经济学的成本效果分析(CEA)进行评价。结果:5组方案的成本效果比(C/E)分别为57.34,61.52,59.55,79.37,93.42,以方案0.5 g,bid为参照,0.5 g,tid;0.5 g,qid;1.0 g,bid;1.0 g,tid余下4组方案的增量成本(ΔC/ΔE)对比结果分别为222.32,57.73,36.58,49.83。结论:C/E值最小者可能药效不理想,应结合临床实际选择。0.5 g,qid给药方案的药物经济学评价效果优于0.5 g,tid,且相同每日累积给药量的1.0 g,bid或更高给药剂量的1.0 g,tid方案并未体现出更高收益。Objective：To evaluate the economic effects of different dosing regimens of imipenem for anti postoperative infection therapy. Methods：Anamnesis of the patients hospitalized for surgical operation during the year of 2009 to 2010 in Peking university people＇s hospital were investigated. 119 patients administered with imi- penem after operation for anti-infection treatment were selected and divided into 5 groups according to imipenem do- sing regimens, i. e. , 0.5 g bid, 0.5 g tid, 0.5 g qid, 1.0 g bid and 1.0 g tid. Those dosing regimens were evalua- ted with Monte Carlo stimulation （MCS） and assessed with pharmacoeconomic cost-effectiveness analysis. Cumula- tive fraction of responses （CFRs）were calculated as the output results of MCS. Results： The C/E values of the 5 groups were 57.34, 61.52 the reference, the AC/AE , 59.55, 79.37, and 93.42, re of the other 4 regimens were 222 spective .32, 57 ly. Taking the C/E value of 5 mg bid group as 73, 36.58 and 49.83, respectively. Conclusion： The regimen with the least cost might not be effective enough against target bacteria, and selection of dosing regimen m 0.5 g tid ust be made combining clinical situation. For imipenem, 0.5 g qid was shown to be more effective than pharmacoeconomic perspective. Furthermore, neither 1.0 g bid which was of the same daily dose as O. 5 g qid nor 1.0 g tid performed better than 0. 5 g qid.

关 键 词：亚胺培南 药物经济学 蒙特卡洛模拟 外科手术 成本效果分析 

分 类 号：R978[医药卫生—药品]