抗菌药物联合应用治疗肺炎链球菌感染的成本与疗效分析  

Cost-efficacy of combination use of antibiotics in treatment of Streptococcus pneumoniae infections

作　　者：赵冰冰[1] 王国栋[1] 李嘉盈[1] 

机构地区：[1]天津医科大学第二医院药剂科,天津300061

出　　处：《中华医院感染学杂志》2014年第14期3455-3457,共3页Chinese Journal of Nosocomiology

基　　金：天津市卫生局基金资助项目(TW-2010B-1023)

摘　　要：目的探讨抗菌药物联合应用治疗肺炎链球菌感染的成本-疗效,寻找最经济治疗肺炎链球菌感染的抗菌药物应用方案。方法选取2013年1-3月肺炎链球菌感染患者108例,随机分为3组,其中A组38例、B组33例、C组37例,A组患者给予头孢哌酮/舒巴坦治疗,B组患者给予氨苄西林/舒巴坦治疗,C组患者给予阿莫西林/克拉维酸治疗,对3组患者的治疗效果和治疗成本进行评价和统计,并计算成本-疗效比。结果 A、B、C 3组治疗有效率分别为86.84%、81.82%和94.59%,3组患者之间临床有效率比较差异有统计学意义(P<0.05);A、B、C 3组治疗方案成本-疗效比分别为12.57、13.67和14.16,A组最低,C组方案虽然疗效最好,但是成本疗效比最高,与B方案相比,每增加1单位治疗有效率,C组方案需要增加成本17.30元;进行敏感度分析发现,随着药品价格的下调,3种治疗方案的成本-疗效比分别为11.31、12.30和12.74,与调价前相比改变不大。结论 3种方案对于经济条件较好的患者可以选择阿莫西林/氨苄西林进行治疗,而对于经济状况一般或者较差的患者,则可以选择头孢哌酮/舒巴坦治疗,价格调整对其成本-疗效影响不大。OBJECTIVE To explore the cost-efficacy of combination use of antibiotics in treatment of Streptococcus pneumoniae infections and look for a most economical medication program for treatment of the S.pneumoniaeinfections.METHODS From Jan to Mar 2013,a total of 108patients with S.pneumoniaeinfections were enrolled in the study and randomly divided into the group A with 38cases,the group B with 33cases,and the group C with37cases;the group A was treated with cefoperazone-sulbactam,the group B treated with ampicillin-sulbactam,the group C treated with amoxicillin-clavulanic acid;the therapeutic effect and the treatment cost of the three groups were evaluated and statistically analyzed,and the cost-efficacy was calculated.RESULTS The effective rate of treatment was 86.84%in the group A,81.82%in the group B,94.59%in the group C,and the difference in the effective rate of treatment between the three groups was significant（P〈0.05）.The cost-efficacy of treatment program was 12.57in the group A,13.67in the group B,14.16in the group C,although the efficacy was the best in the group C,the cost-efficacy was the highest;as compared with the group B,the cost could be increased for 17.30yuan in the group C when the effective rate of treatment increased for each one unit.The analysis of sensitivity indicated that with the medicine price being cut,the cost-efficacy was 11.31in the group A,12.30in the group B,12.74in the group C,which did not change significant as compared with that before the price was adjusted.CONCLUSION As for the three medication programs,the patients with good economic condition can choose amoxicillin-ampicillin for treatment,and the patients with poor economic condition can choose cefoperazone-sulbactam,and the adjustment of price has little impact on the cost-efficacy.

关 键 词：肺炎链球菌 感染 抗菌药物 联合用药 成本-疗效 分析 

分 类 号：R978.1[医药卫生—药品]