我院抗菌药物治疗儿童社区获得性肺炎疗效评价及成本-效果分析

目的：评价我院抗菌药物治疗儿童社区获得性肺炎（CAP）的疗效并进行成本-效果分析，为临床提供参考。方法：将我院2012年1月至2013年1月收治的202例中、重度CAP患儿，按抗菌药物治疗方案分为五组——I组（37例）：头孢呋辛钠＋阿奇霉素；II组（32例）：头孢噻肟钠＋阿奇霉素；Ⅲ组（48例）：头孢哌酮钠／舒巴坦钠＋阿奇霉素；1V组（44例）：头孢他啶＋阿奇霉素；V组（41例）：头孢吡肟＋阿奇霉素。评价各组临床疗效和不良反应，并进行成本-效果分析。结果：五组总有效率分别为75．68％、78．13％、85．42％、86．36％、82．93％，病原菌清除率分别为76．47％、78．57％、82．61％、85．71％、84．21％，不良反应发生率分别为2．70％、3．13％、4．17％、4．55％、4．88％，组间比较差异均无统计学意义（P均〉O．05）。应用经济学原理分析显示I组成本最小（539．35元），V组最大（626．36元）；计算各组的C／E值，Ⅳ组最小（6．80），V组最大（7．55）；以成本最小的I组为参照计算各组△c／△E值，Ⅳ组最小（4．49），V组最大（12．00）。结论：五组总有效率、细菌清除率和不良反应发生率相当，但Ⅳ组（头孢他啶＋阿奇霉素）最经济，为治疗儿童CAP的首选方案。

Clinical Efficacy and Cost-Effectiveness Analysis of Antibiotic Therapy in Community-Acquired Pneumonia in Our Hospital

Objective： The clinical efficacy and cost-effectiveness of antibiotic therapy in pediatric community-acquired pneumonia （CAP） in our hospital were analyzed for clinical reference. Methods： According to the kinds of antimicrobial agents, 202 cases of pediatric patients with CAP in hospital from January 2012 to January 2013 were randomly divided into five groups. The clinical efficacy, adverse reactions and cost-effectiveness of each group were analyzed. Results： The rates of total efficiency, bacterial clearance and ADR incidence of the five groups had no significant difference （P〉0.05）. The analysis results by using economic principles showed that the cost was lowest in the group I （539.35 RMB）, and highest in the group V （626.36 RMB） ; C/E value was minimum in the group IV （6.80） , and maximum in the group V （7.55） ; △C/△E value was minimum in the group IV （4.49） , and maximum in the group V （12.00） by using the group I as a reference. Conclusions： The rates of total efficiency, bacterial clearance and ADR incidence of the five groups had no difference. The therapy of the group IV was the most economic, and should be the best treatment of CAP for children.