3种抗菌方案治疗成人中、重度下呼吸道感染的疗效与药物经济学评价

摘要

目的：探讨3种抗菌方案治疗成人中、重度下呼吸道感染的疗效与药物经济学评价。方法：选取2013年1月—2014年12月中、重度下呼吸道感染住院患者300例，以随机数字表法分为A组（头孢曲松钠组）100例、B组（莫西沙星组）100例、C组（头孢曲松钠＋阿奇霉素组）100例。观察3组患者的临床疗效，运用成本－效果分析法对3种方案进行药物经济学评价。结果：A、B、C 3组患者的总有效率分别为65．00％（65／100）、93．00％（93／100）、97．00％（97／100） ， B、C组患者的总有效率明显高于A组，差异均有统计学意义（ P＜0．05）；A、B、C 3组患者的药物治疗成本分别为435．52、2120．88、711．52元，成本－效果比分别为6．70、22．81、7．34；B、C组相对于A组的增量成本－效果比分别是60．19、8．63；3组患者均未发生与治疗药物相关的严重不良反应。结论：C组（头孢曲松钠＋阿奇霉素）的成本－效果最高，是治疗成人中、重度下呼吸道感染的优先选择方案。%OBJECTIVE:To evaluate the cost-effectiveness of three antimicrobial schemes for patients with moderate or severe lower respiratory tract infection.METHODS:300 patients with moderate or severe lower respiratory tract infection from January 2013 to December 2014 were randomly divided into three groups, of 100 cases each.The patients were treated with ceftriaxone sodium in group A, moxifloxacin in group B and ceftriaxone sodium plus azithromycin in group C.The three groups were followed with regard to clinical efficacy and cost-effectiveness. RESULTS:The effective rates of group A, B and C were 65.00%(65/100), 93.00%(93/100) and 97.00%(97/100), respectively, indicating that the effective rates in group B and C were significantly higher than in group A(P<0.05). The drug costs of three groups were 435.52, 2 120.88 and 711.52 Yuan, respectively and the cost-effectiveness ratios were 6.70, 22.81 and 7.34 respectively.The incremental cost-effectiveness ratios of group B and C versus group A were 60.19 and 8.63 respectively.No severe adverse reactions were found in the 3 groups.CONCLUSIONS: Among three groups, group C( ceftriaxone sodium combined azithromycin) was the highest in cost-effectiveness, which thus is the optimal choice for treatment of lower respiratory tract infection.