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目的:评价头孢吡肟、头孢哌酮/舒巴坦与美罗培南治疗成人下呼吸道感染的临床疗效及经济学意义。方法:80例下呼吸道感染患者随机分为3组,分别给予头孢吡肟、头孢哌酮/舒巴坦、美罗培南进行抗感染治疗,统计分析3组临床疗效、细菌学效果及安全性,并进行成本-效果分析。结果:3组临床有效率分别为96.4%、92.6%、96.0%,差异无统计学意义(P>0.05);细菌清除率分别为78.6%、77.8%、80.0%,差异无统计学意义(P>0.05);不良反应发生率分别为14.3%、11.1%、8.0%,差异无统计学意义(P>0.05);组间治疗成本的高低与治疗药物成本的变化密切相关,成本-效果比(C/E)分别为71.4、66.1、75.1,头孢吡肟、美罗培南相对于头孢哌酮/舒巴坦的增量成本-效果比(△C/△E)分别为200.3、317.6。结论:头孢哌酮/舒巴坦是最具成本-效果的治疗下呼吸道感染药物。
Objective: To evaluate the clinical efficacy and economic significance of cefepime, cefoperazone / sulbactam and meropenem in the treatment of adult lower respiratory tract infection. Methods: Eighty patients with lower respiratory tract infection were randomly divided into three groups and were given cefepime, cefoperazone / sulbactam and meropenem respectively for anti-infective therapy. The clinical efficacy, bacteriological efficacy and safety of the three groups were statistically analyzed. Conduct cost-effectiveness analysis. Results: The clinical effective rates of the three groups were 96.4%, 92.6% and 96.0% respectively, with no significant difference (P> 0.05). The bacterial clearance rate was 78.6%, 77.8% and 80.0% respectively, with no significant difference (P > 0.05). The rates of adverse reactions were 14.3%, 11.1% and 8.0%, respectively. There was no significant difference between the two groups (P> 0.05). The cost of treatment was closely related to the cost of treatment. The cost- C / E) were 71.4, 66.1, 75.1 respectively. The incremental cost-effect ratio (C / E) of cefepime and meropenem to cefoperazone / sulbactam was 200.3 and 317.6 respectively. Conclusion: Cefoperazone / sulbactam is the most cost-effective treatment for lower respiratory tract infections.