万古霉素、利奈唑胺治疗MRSA感染的成本效益分析

摘要

目的 比较和分析万古霉素与利奈唑胺在治疗自耐甲氧西林金黄色葡萄球菌(MRSA)感染方面的区别与联系,为临床合理用药提供理论依据.方法 采用回顾性分析,选取2014年1月-2016年3月西安医学院第一附属医院存在MRSA感染并使用万古霉素或(和)利奈唑胺治疗的病例资料,比较患者使用万古霉素与利奈唑胺的疗效和药物经济学情况,评价其合理性.结果 在治疗MRSA感染时,利奈唑胺对肾功能的影响低于万古霉素(P <0.05);万古霉素组的疗程和住院天数分别为(7.04±0.45)d、(10.76±0.53)d,利奈唑胺组疗程和住院天数分别为(5.12±0.47)d、(8.06±0.58)d,两者疗程与住院天数差异有统计学意义(P <0.05);药物利用指数(DUI)均<1.利奈唑胺有效率高于万古霉素(P <0.05);利奈唑胺的成本效果比(C/E)低于万古霉素.结论 与万古霉素比较,在治疗MRSA感染过程中.利奈唑胺对肾功能的影响小、成本效益更优、疗效及安全性更好.%Objective To investigate the cost-effect of Vancomycin and Linezolid in the treatment of MRSA infection, providing practical basis for clinical drug use. Methods Patients admitted into our hospital duringfrom January 2014 to March 2016 were retrospectively analyzed. All cases of MRSA infection using Vancomycin or (and) Linezolid as antibiotic therapy were included in this study. The efficacy and pharmacogenomics of Linezolid and Vancomycin in treatment of MRSA were recorded. Results Incidence of renal function in linezolid Linezolid group was significantly lower than that in Vancomycin group (P < 0.05). Time duration of antibiotics usage in Vancomycin group were prolonged compared with linezolid Linezolid group [(7.04 ± 0.45) d vs (5.12 ± 0.47), P < 0.05]. Longer hospitalization stay was also identified in Vancomycin group compared with Linezolid group [(10.76 ± 0.53) d vs (8.06 ± 0.58) d, P < 0.05]. DUI of Vancomycin and Linezolid were both less than 1, while therapeutic effectiveness and cost-effectiveness ratio (C/E) of Linezolid was significantly higher than that in Vancomycin group (P < 0.05).Conclusion Linezolid may be a better choice for treatment of MRSA due to better cost-effectiveness, efficacy and safety compared with Vancomycin.