老年社区获得性肺炎两种药物治疗方案的最小成本分析

发布时间：2018-03-30 20:24

本文选题：社区获得性肺炎　切入点：老年患者　出处：《中国药房》2017年23期

【摘要】：目的:对比莫西沙星单用与哌拉西林他唑巴坦联合阿奇霉素治疗老年社区获得性肺炎(CAP)的临床效果、不良反应与成本。方法:采用回顾性研究法,选取某"三甲"医院呼吸内科2015年10月-2016年4月收治的老年CAP住院患者60例,按给药方案不同分为A、B组,各30例。A组患者给予盐酸莫西沙星氯化钠注射液250 m L,ivgtt,qd;B组患者给予注射用乳糖酸阿奇霉素0.50 g,ivgtt,qd+注射用哌拉西林钠他唑巴坦钠3.375 g,ivgtt,q8 h。两组疗程均为10 d。比较两组患者的临床疗效、细菌学疗效及不良反应发生情况,并评价两种药物方案的经济性。结果:A、B组患者的临床总有效率分别为90.00%、93.33%,细菌清除率分别为85.00%、86.36%,不良反应发生率分别为3.33%、6.67%,两组比较差异均无统计学意义(P0.05)。故采用最小成本分析法进行经济学评价,可得A组的治疗成本为16 646.51元,B组为19 605.74元,A组成本低于B组;敏感度分析支持最小成本分析结果。结论:老年CAP住院患者在使用抗菌药物进行经验性治疗时,宜首选莫西沙星单用,该方案疗效确切、花费较低、安全性较高。
[Abstract]:Objective: to compare the clinical effect, adverse reactions and cost of moxifloxacin alone with piperacillin tazobactam combined with azithromycin in the treatment of elderly patients with community-acquired pneumonia. Sixty elderly CAP patients admitted from October 2015 to April 2016 in Department of Respiratory Medicine in a "Sanjia" hospital were selected and divided into two groups according to the drug regimen. 30 patients in group A were treated with moxifloxacin hydrochloride and sodium chloride injection 250ml / d iv / qdN group B patients were given azithromycin lactate 0.50 g / d iv gt QD for injection of piperacillin sodium tazobactam sodium 3.375 g / g tazobactam sodium iv q8 h.The course of treatment was 10 days and the clinical efficacy was compared between the two groups. Bacteriological efficacy and adverse reactions, Results the total effective rate of the patients in group B was 90.000.3333, the clearance rate of bacteria was 85.00 and 86.36.The incidence of adverse reactions was 3.336.67.The difference between the two groups was not statistically significant (P 0.05). The cost analysis method is used to evaluate the economics. The cost of treatment in group A was 16 646.51 yuan. The cost of group A was 19 605.74 yuan. Sensitivity analysis supported the results of minimal cost analysis. Moxifloxacin alone should be chosen as the first choice. This regimen is effective, low cost and high safety.
【作者单位】：南京医科大学第二附属医院药学部;南京医科大学第二附属医院呼吸内科;南京医科大学药学院;
【基金】：江苏省药学会-奥赛康医院药学基金立项课题(No.201504)
【分类号】：R563.1

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