我院常用头孢类抗生素治疗儿童肺炎的成本-效果分析

目的:探讨头孢噻肟、头孢曲松等5种头孢菌素治疗儿童肺炎的成本-效果.方法:采用回顾性研究和成本-效果分析方法,对儿童肺炎成本进行药物经济学评价.结果:在达到基本一致(P＞0.05)的治疗效果时,头孢噻肟、头孢曲松、头孢哌酮的成本及成本-效果较低,其余2种头孢菌素的这两项指标均有大幅提高.结论:与其他4种头孢菌素比较,用头孢曲松治疗儿童肺炎具有费用适中,成本-效果比及ADR发生率较低等优点.     

我院6种头孢类抗生素治疗儿童肺炎的经济学分析

目的探讨头孢噻肟、头孢曲松等6种头孢菌素治疗儿童肺炎的成本-效果。方法采用回顾性研究和成本-效果分析方法,对儿童肺炎成本进行药物经济学评价。结果在达到基本一致(P>0.05)的治疗效果时,头孢噻肟,头孢曲松,头孢哌酮的成本及成本-效果较低,而其他三种头孢菌素的这二项指标均有大幅提高。结论与其他5种头孢菌素比较,用头孢曲松治疗儿童肺炎具有费用适中,成本-效果比及ADR发生率较低等优点。     

4种头孢类抗生素治疗儿童支气管肺炎的成本-效果分析

目的 :研究头孢唑啉、头孢三嗪、头孢噻肟和头孢呋辛治疗儿童支气管肺炎的成本 -效果。方法 :采用回顾性研究和成本 -效果分析法 ,计算儿童支气管肺炎患者的治疗成本 ,进行药物经济学评价。结果 :头孢唑啉、头孢三嗪、头孢呋辛、头孢噻肟治疗儿童支气管肺炎的成本分别为512 84、725 42、796 28、734 16元。成本 -效果比分别为93 68、475 83、517 30、412 28。结论 :与头孢三嗪、头孢呋辛和头孢噻肟相比 ,用头孢唑啉治疗儿童支气管肺炎最经济 ,但在评价某一药物治疗成本的同时 ,必须考虑药物的疗效和疗程     

两种头孢菌素类药物在儿童支气管肺炎中的药物经济学分析

目的：探讨两种头孢菌素类药物在儿童支气管肺炎中的成本效果。方法所选100例支气管肺炎患儿均为本院2010年9月~2013年9月期间收治患儿，上述患儿随机分为观察组和对照组。观察组患儿给予头孢曲松治疗，对照组给予头孢他啶治疗。均连续治疗7d。评定治疗效果。结果观察组总有效率与对照组总有效率近似，差异无统计学意义（P〉0.05）。观察组成本效果为455/0.94=484.0；对照组成本效果为770/0.96=802.0。观察组成本效果低于对照组，观察组患儿治疗后，每取得一个治疗单位，其成本低于对照组。结论头孢曲松和头孢他啶治疗儿童支气管肺炎均获得较好临床治疗效果，但头孢曲松的治疗成本低于头孢他啶，值得借鉴。     

5种头孢菌素对儿童肺炎患者临床疗效的成本-效果分析

目的:分析5种头孢类抗生素对儿童肺炎患者临床疗效的成本-效果。方法:选取2014年1月—2015年3月间收治的150例儿童肺炎患者作为研究对象,将其分为A,B,C,D和E组,每组30例;各组患者分别给予头孢替唑钠、头孢呋辛钠、头孢他啶、头孢美唑钠和头孢曲松钠治疗,分析治疗后各组患者的临床疗效的成本-效果。结果:5种头孢类抗生素对儿童肺炎患者临床治疗的总有效率经比较其差异无统计学意义(P>0.05);但是头孢曲松钠与其他4种头孢菌素相比,其成本-效果比重偏低,经比较其差异有统计学意义(P<0.05)。结论:与其他4种头孢菌素相比,头孢曲松钠用于治疗儿童肺炎患者疗效的成本-效果较为明显。     

3种头孢菌素治疗新生儿败血症的药物经济学分析

目的:研究头孢噻肟、头孢他啶、头孢呋辛治疗新生儿败血症的药物经济学效果.方法:用决策分析方法对3种头孢菌素类抗生素治疗新生儿败血症的期望成本、成本-效果和治愈成本进行分析.结果:头孢噻肟、头孢他啶、头孢呋辛治疗新生儿败血症均取得较好疗效,但药物治疗期望成本、成本-效果、治愈成本分析均显示头孢他啶组优于其它二组药物.结论:从药物经济学角度来看,头孢他啶治疗新生儿败血症优于头孢呋辛与头孢噻肟.     

4种头孢类抗生素治疗儿童支气管肺炎的成本－效果分析

目的研究头孢唑啉、头孢三嗪、头孢噻肟和头孢呋辛治疗儿童支气管肺炎的成本－效果。方法采用回顾性研究和成本－效果分析法,计算儿童支气管肺炎患者的治疗成本,进行药物经济学评价。结果头孢唑啉、头孢三嗪、头孢呋辛、头孢噻肟治疗儿童支气管肺炎的成本分别为512.84、725.42、796.28、734.16元。成本－效果比分别为93.68、475.83、517.30、412.28。结论与头孢三嗪、头孢呋辛和头孢噻肟相比,用头孢唑啉治疗儿童支气管肺炎最经济,但在评价某一药物治疗成本的同时,必须考虑药物的疗效和疗程。     

头孢曲松与头孢噻肟治疗下呼吸道感染成本—效果分析

目的：探讨头孢曲松与头孢噻肟治疗轻中度下呼吸道感染的经济效果。方法：将200例患者随机分为两组,A组（头孢曲松）103例,B组（头孢噻肟）97例,用药物经济学方法进行成本-效果分析。结果：A,B组治疗方案的痊愈率分别为38.8%,24.7%,有效率分别为80.6%,65.0%,A组的成本-效果比在治疗三种下呼吸道感染中均低于B组。结论：头孢曲松治疗轻中度下呼吸道感染优于头孢噻肟,且副作用较少。     

四种药物治疗儿童下呼吸道感染最小成本比较

目的:对头孢噻肟、头孢曲松、头孢他啶、头孢哌酮/舒巴坦治疗儿童下呼吸道感染的最小成本比较。方法:采用药物经济学最小成本比较法,计算治疗成本。结果:四种药物的经济学评价结果 A、B、C、D 组均用药天数(d)及均总住院费(元)依次为:5.95,4.44,4.24,5.70;914.95,963.60,1252.40,1610.70。结论:头孢曲松为治疗儿童下呼吸道感染最有效且经济的药物。     

第三代抗菌素的不良反应特点与合理应用

抗生素是临床治疗各种感染必不可少的药物,头孢菌素类抗生素因其抗菌作用强,耐β-内酰胺酶、临床疗效高、毒性较低、过敏反应较青霉素少等优点而被广泛应用于临床。但随着临床的广泛应用,其不良反应（ADR）也时有报道,其中又以包括头孢哌酮、头孢噻肟、头孢曲松、头孢他啶等在内的第三代头孢菌素的ADR报道较为普遍,已引起了医药界的广泛关注。     

6种抗菌药物方案治疗细菌性肺炎的成本-效果分析

目的:评价6种抗菌药物方案治疗细菌性肺炎的成本-效果.方法:将214例细菌性肺炎患者随机分为6组(A、B、C、D、E、F),分别给予哌拉西林他唑巴坦 阿米卡星、左氧氟沙星、头孢曲松、克林霉素、美洛西林、阿奇霉素,观察各组疗效并进行成本-效果分析.结果:6组患者总有效率分别为91.42%,83.33%,89.19%,78.79%,81.08%,77.78%(P>0.05);6种治疗方案总成本分别为2 795.17,1 438.79,1 350.05,1 796.75,1 769.64,1267.89元;成本-效果比分别为30.57,17.33,15.14,22.80,21.83,16.30;以F组为参照的增量成本-效果比为111.97,30.79,7.20,523.62,152.04,…….结论:头孢曲松钠治疗细菌性肺炎较佳.     

2种抗生素联用方案治疗儿童肺炎的成本-效果分析

目的比较2种抗生素联用方案治疗儿童肺炎的经济学效果。方法采用回顾性调查方法,对阿莫西林/克拉维酸钾(5∶1)与哌拉西林钠/舒巴坦钠(2∶1)治疗儿童肺炎进行成本-效果分析。结果2种方案总有效率分别为94%、96%(P>0.05);成本分别为926.40、1370.30元(P<0.05);成本-效果比分别为9.85、14.27元。结论阿莫西林/克拉维酸钾治疗儿童肺炎比哌拉西林钠/舒巴坦钠经济。     

Ceftriaxone. A pharmacoeconomic evaluation of its use in the treatment of serious infections

Ceftriaxone possesses a broad spectrum of antimicrobial activity that includes the Gram-positive and Gram-negative aerobes commonly associated with serious infections. Its therapeutic efficacy is comparable to that of other third-generation cephalosporins and aminoglycoside-combination regimens. The most commonly reported adverse events with ceftriaxone are similar in incidence and severity to those reported with other third-generation cephalosporins. Notably, the drug has a favourable pharmacokinetic profile which allows once-daily administration. In comparative studies with other parenteral regimens requiring 3 to 6 daily doses, treatment with once-daily ceftriaxone reduced total antimicrobial drug costs (i.e. acquisition, preparation and administration costs) by 17 to 52%. Ceftriaxone was also more cost effective than ceftazidime and a variety of other antimicrobial treatment regimens (penicillins, cephalosporins, combination regimens) in the treatment of patients with community-acquired pneumonia or bronchopneumonia. This reflected lower drug and hospitalisation costs associated with a reduced length of hospital stay in ceftriaxone recipients. In noncomparative studies, ceftriaxone achieved considerable hospitalisation cost savings in patients with serious infections (mostly bone, joint, skin/skin structure infections), who were able to receive all or part of their antimicrobial therapy as outpatients. In one analysis which evaluated all direct and indirect costs (such as training programmes, transportation, time for visits and supplies) and benefits (such as hospitalisation cost savings, return to work or school, increased productivity) of outpatient ceftriaxone therapy, the overall benefit-cost ratio was approximately 5:1. The studies to date confirm that ceftriaxone is effective, well tolerated, convenient to administer and, when utilised appropriately, offers the potential for cost avoidance in patients with serious infections. Although additional well designed pharmacoeconomic analyses are needed to further evaluate its cost effectiveness, ceftriaxone should be considered an essential third-generation cephalosporin formulatory representative in most clinical settings.     

Piperacillin/tazobactam: a pharmacoeconomic review of its use in moderate to severe bacterial infections.

Piperacillin/tazobactam is a beta-lactam/beta-lactamase inhibitor combination with a broad spectrum of antibacterial activity against most Gram-positive and Gram-negative aerobic bacteria and anaerobic bacteria. Piperacillin/tazobactam is effective and well-tolerated in patients with lower respiratory tract infections (LRTI), intra-abdominal infections, skin and soft tissue infections, and febrile neutropenia. In comparative clinical trials against various other antibacterial regimens, piperacillin/tazobactam has shown higher clinical success rates, particularly in the treatment of patients with intra-abdominal infections and febrile neutropenia. Cost analyses of piperacillin/tazobactam have been variable, in part, because of differences in specific costs included. Three US cost analyses found that piperacillin/tazobactam had lower total medical costs than clindamycin plus gentamicin or imipenem/cilastatin in intra-abdominal infections, and ticarcillin/ clavulanic acid in community-acquired pneumonia. Piperacillin/tazobactam plus amikacin had lower total costs than ceftazidime plus amikacin in another cost analysis of patients with febrile neutropenic episodes modelled in nine European countries. However, piperacillin/tazobactam plus tobramycin was more costly than ceftazidime plus tobramycin in hospital-acquired pneumonia in a US cost analysis. In cost-effectiveness analyses, all studies of intra-abdominal infections, pneumonia and febrile neutropenic episodes consistently reported lower costs per unit of effectiveness versus comparators. Piperacillin/tazobactam was dominant (greater efficacy and lower costs) versus imipenem/cilastatin in intra-abdominal infections and ceftriaxone, ciprofloxacin or meropenem in pneumonia. Piperacillin/tazobactam plus amikacin was dominant over ceftazidime plus amikacin in the treatment of febrile neutropenic episodes. In a cost-effectiveness analysis of skin and soft tissue infection, piperacillin/tazobactam had lower costs per successfully treated patient than ceftriaxone or cefotaxime, but a slightly higher cost-effectiveness ratio than amoxicillin/clavulanic acid. All cost-effectiveness analyses were based on decision-analytical models. CONCLUSIONS: Piperacillin/tazobactam is likely to reduce overall treatment costs of moderate to severe bacterial infections by increasing initial treatment success, thereby reducing the length of hospital stay and the use of additional antibacterials. Piperacillin/tazobactam has shown clinical and economic advantages over standard antibacterial regimens in the treatment of intra-abdominal infections, LRTIs, febrile episodes in patients with neutropenia, and skin and soft tissue infections, although more complete published data are needed to confirm these results. Present data regarding clinical efficacy, bacterial resistance and costs would support the use of piperacillin/tazobactam as an empirical first-line option in moderate to severe bacterial infections.     

不同抗菌药物治疗新生儿肺炎的临床价值探讨

目的分析不同抗菌药物治疗新生儿肺炎的临床效果。方法 66例新生儿肺炎患儿作为研究对象,对其临床资料进行回顾性分析,研究不同抗菌药物在患儿临床治疗中的应用效果。结果 66例患儿共使用青霉素类药物60次,头孢菌素类药物76次。患儿应用不同抗菌药物治疗方案主要分为3种,分别为单一应用青霉素类,单一应用头孢菌素类以及青霉素类联合头孢菌素类,三组患儿的痊愈时间分别为(4.86±1.30)、(4.80±1.28)、(4.92±1.22)d,两两比较差异无统计学意义(P>0.05)。结论在新生儿肺炎的临床治疗中,应用不同抗菌药物的治愈时间相对一致,因此,需谨慎选择合理的抗菌药物治疗方案,尽可能使用单一药物治疗,进而为患儿的生命安全提供保障。     

痰热清注射液与头孢曲松钠联合应用治疗急性肺炎的疗效

目的探讨痰热清注射液与头孢曲松钠联合应用治疗急性肺炎的疗效。方法 78例确诊为急性肺炎患者被随机分为观察组和对照组,每组39例,对照组患者给予头孢曲松钠治疗,观察组患者给予痰热清注射液联合头孢曲松钠治疗。比较两组临床效果。结果观察组患者的咳嗽、咳痰、发热及啰音消失时间均少于对照组患者,且临床疗效也显著优于对照组患者,差异有统计学意义（P〈0.05）。结论痰热清注射液联合头孢曲松钠治疗急性肺炎的疗效确切,值得临床进一步推广使用。     

Safety evaluation of cephalosporins based on utilization and adverse drug events: analysis of two databases in China

Objective: The aim of this study is to evaluate the safety of cephalosporins, based on utilization and adverse drug events (ADEs). Methods: This is a retrospective study using data on cephalosporins, obtained from Yangtze River hospital drug information and the Wuhan adverse drug reactions monitoring center database, from January 2009 to December 2010, in 30 hospitals in China. Results: 22/44 (55%) cephalosporins were third-generation, which accounted for more than 50% of total expenditure. The top five cephalosporins (sorted by their defined daily doses) were cefodizime sodium, cefoperazone/sulbactam sodium, cefaclor, cefixime and cefmenoxime hydrochloride, which were used 182.93, 110.63, 109.09, 101.47 and 100.05 defined daily dose per 10,000 days, respectively. Third-generation cephalosporins were responsible for 747/1337 ADEs (55.87%). In particular, 208 episodes (15.56%) were associated with ceftriaxone. The most frequently reported damages were involved in the skin and its appendages (967, 68.92%). 603 (45.10%) were identified as definite in causality evaluation. Cefaclor was found to be safer than other cephalosporins, whereas ceftriaxone was found to be less safe. Conclusion: This retrospective evaluation demonstrated that overused and misused cephalosporins caused a relatively high incidence of ADEs. Therefore, surveillance should be strengthened successfully to optimize the rational use of cephalosporins.     

医院获得性肺炎4种治疗方案的成本-效果分析

目的 :评价4种治疗方案的药物经济学效果。方法 :运用成本—效果分析法对4种治疗方案进行分析。结果 :头孢曲松、亚胺培南的成本 -效果比基本相当 ,较头孢呋辛与庆大霉素联合用药的成本 -效果比低 ;头孢曲松成本较低 ,而亚胺培南治愈率及总有效率最高 ;哌拉西林与丁胺卡那联合用药的成本最低 ,但治愈率和有效率亦低。结论 :药物经济学在优化治疗方案、指导合理用药、提高经济效益方面具有重要作用     

3种抗菌药治疗老年性肺炎的药物经济学评价

目的：评价3种抗菌药治疗老年性肺炎的疗效及经济效果。方法：选择372例老年性肺炎患者，随机分为3组，分别给予头孢曲松钠、左氧氟沙星、洛关沙星治疗，观察各组疗效并运用药物经济学方法进行分析。结果：3组治疗有效率分别为80．65％、87．1％、72．58％；不良反应发生率分别为7．65％、6．35％、13．81％。平均成本一效果比分别为6528、10392、11196。结论：药物经济学分析结果为头孢曲松钠优于左氧氟沙星，优于洛关沙星。