3种方案治疗A族β溶血性链球菌致急性上呼吸道感染的最小成本分析

发布时间：2018-05-22 14:51

本文选题：A族β溶血性链球菌 + 急性上呼吸道感染　；参考：《中国药房》2017年17期

【摘要】：目的:对治疗A族β溶血性链球菌(GAS)致急性上呼吸道感染的3种方案的经济性进行评价。方法:采用回顾性研究方法,选择我院2014年3月-2016年3月临床表现为急性上呼吸道感染且用咽拭子试验分离出GAS呈阳性的患者71例,按用药方法不同分为A组(16例)、B组(30例)和C组(25例)。A、B、C组患者分别采用一次性肌内注射苄星青霉素(120万U)、口服青霉素V钾(约0.5 g,q8 h,疗程10 d)、口服阿莫西林舒巴坦匹酯(1.0 g,bid,疗程10 d)3种治疗方案,观察临床疗效及细菌清除情况,并对3种方案进行经济学评价。结果:3组患者的治愈率分别为87.50%、90.00%、92.00%,细菌清除率分别为88.24%、87.88%、92.59%,差异均无统计学意义(P0.05),故采用最小成本分析法进行药物经济学评价。3种方案的成本分别为237.79、279.49、400.40元,其中C方案的治愈率和细菌清除率最高,但成本也最高。敏感度分析结果与最小成本分析结果一致。结论:对于明确病原性细菌为GAS所致的反复发作的上呼吸道感染且有诱发风湿热风险的患者,肌内注射苄星青霉素可作为首选治疗方案;对于不愿接受注射用青霉素治疗且能保证用药时间的患者,可选择口服青霉素V钾;对于普通青霉素治疗效果不佳的患者,可选择口服阿莫西林舒巴坦匹酯。
[Abstract]:Objective: to evaluate the economy of three methods for the treatment of acute upper respiratory tract infection caused by group A 尾 hemolytic streptococcus. Methods: a retrospective study was carried out in 71 patients with acute upper respiratory tract infection (ARI) from March 2014 to March 2016 and GAS positive by pharynx swab test. Patients in group A (n = 16) and group C (n = 25) were treated with a single intramuscular injection of benzylpenicillin (1.2 million U) and penicillin V potassium (0.5 g / g Q8 h) for 10 days. Tampiramate 1.0 g bid, treatment course 10 days, 3 kinds of treatment plan, The clinical efficacy and bacterial clearance were observed, and the economic evaluation of three schemes was carried out. Results the cure rates of the three groups were 87.50 and 90.000.The bacterial clearance rates were 88.24 and 87.889.599.The difference was not statistically significant, so the cost of using the least cost analysis method to evaluate the pharmacoeconomics of the three schemes was 237.79279.49.400.40 yuan, respectively. Among them, the cure rate and bacterial clearance rate of C regimen were the highest, but the cost was also the highest. The result of sensitivity analysis is consistent with that of minimum cost analysis. Conclusion: for patients with recurrent upper respiratory tract infection caused by GAS and risk of rheumatic fever, intramuscular injection of benzylpenicillin can be the first choice. Patients who do not want to be treated with penicillin for injection and who can guarantee the duration of drug use can choose penicillin V potassium orally, and patients with poor efficacy of penicillin can choose amoxicillin sulbactam.
【作者单位】：西南大学医院药剂科;西南大学医院眼耳鼻喉科;重庆市第六人民医院药剂科;
【基金】：西南大学基本科研业务费专项资金项目(No.XDJK2014C084)
【分类号】：R56

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