6种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,其余3种头孢菌素的这两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。     

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     

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.     

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。     

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。     

The in vitro antibacterial activity of ceftriaxone in comparison with nine other antibiotics

Summary

The results of a large three centre co-ordinated study into the in vitro susceptibility of bacterial clinical pathogens showed no significant evidence of regional variation within the U.K. towards the 10 antibiotics examined. The newer cephalosporins were highly potent and superior to other antibiotics against the Enterobacteriaceae, with ceftriaxone and cefotaxime the most potent. Against Pseudomonas aeruginosa, gentamicin was the most active, followed by ceftazidime, piperacillin and ceftriaxone; cefotetan was the least active. Staphylococcus aureus and Staphylococcus albus were most susceptible to cefuroxime and gentamicin, though most were also susceptible to ceftriaxone, cefotaxime and cefoxitin. Streptococcus (Groups A and B), Streptococcus pneumoniae and Neisseria spp. were susceptible to most agents other than gentamicin, but ceftriaxone and cefotaxime were overall the most potent. Ceftriaxone was the most active agent against Haemophilus influenzae. The newer agents were variable and relatively poor against anaerobes and only amoxycillin and piperacillin were significantly active against Streptococcus faecalis. The overall resistance level to the third generation cephalosporins was low.     

The in vitro antibacterial activity of ceftriaxone in comparison with nine other antibiotics

The results of a large three centre co-ordinated study into the in vitro susceptibility of bacterial clinical pathogens showed no significant evidence of regional variation within the U.K. towards the 10 antibiotics examined. The newer cephalosporins were highly potent and superior to other antibiotics against the Enterobacteriaceae, with ceftriaxone and cefotaxime the most potent. Against Pseudomonas aeruginosa, gentamicin was the most active, followed by ceftazidime, piperacillin and ceftriaxone; cefotetan was the least active. Staphylococcus aureus and Staphylococcus albus were most susceptible to cefuroxime and gentamicin, though most were also susceptible to ceftriaxone, cefotaxime and cefoxitin. Streptococcus (Groups A and B), Streptococcus pneumoniae and Neisseria spp. were susceptible to most agents other than gentamicin, but ceftriaxone and cefotaxime were overall the most potent. Ceftriaxone was the most active agent against Haemophilus influenzae. The newer agents were variable and relatively poor against anaerobes and only amoxycillin and piperacillin were significantly active against Streptococcus faecalis. The overall resistance level to the third generation cephalosporins was low.     

Place of parenteral cephalosporins in the ambulatory setting: clinical evidence

During the last decade, 6 parenteral third generation cephalosporins have been introduced into clinical practice. The three most frequently used agents are cefotaxime, ceftazidime and ceftriaxone. Although primarily used in hospitals, these agents are increasingly employed in the ambulatory setting. In particular, ceftriaxone, because of its favourable pharmacokinetic profile allowing once-daily administration by a bolus injection, has demonstrated both tolerability and efficacy in the ambulatory setting during extensive worldwide use. Sophisticated parenteral infusion systems enable cephalosporins that require more frequent administration to be delivered in this setting. In noncomparative studies involving a range of patient populations and serious infections (mostly bone, joint and soft tissue, and pneumonia and febrile episodes in neutropenia), these cephalosporins achieved equivalent efficacy and tolerability, and considerable cost savings, since patients were able to receive all or part of their treatment in the home or outpatient setting. However, more comparative studies of ambulatory parenteral therapy in the inpatient setting or ambulatory oral therapy are necessary to further clarify the true cost effectiveness of this type of healthcare delivery. This is increasingly relevant in countries where parenteral antimicrobials are not the 'standard of care' in managing many serious infections. Published experience to date confirms that third generation cephalosporins, particularly ceftriaxone, should have an essential place in the therapeutic formulary of any ambulatory parenteral antibiotic programme.     

An assessment of the hidden and total antibiotic costs of four parenteral cephalosporins

The aim of this study was to compare the hidden costs, and their impact on total antibiotic costs, of ceftriaxone therapy with those of cefotaxime, ceftazidime and cefuroxime in nosocomial infection. The total antibiotic costs of 7-day standard courses of the 4 cephalosporins were compared. The costs were divided into 3 parts: (i) the cost of the drug itself; (ii) the preparation and administration (labour) costs; and (iii) the consumables and waste costs. The latter 2 costs together comprised the hidden cost of an antibiotic course. Hidden costs were higher for cefotaxime, ceftazidime and cefuroxime, which are normally administered 3 times a day, than for ceftriaxone, which is administered once daily. The percentage contribution of hidden costs to total antibiotic costs increased with decreasing antibiotic cost, and were lower with higher dosages of all antibiotics. With cefotaxime, ceftazidime and cefuroxime, and with ceftriaxone at the lower dosage given by bolus intravenous (IV) injection, the labour component of hidden costs exceeded the consumables/waste component. However, when costs were calculated for ceftriaxone administered at the higher dosage by IV infusion, the costs of consumables and waste were greater than the labour costs. Ceftriaxone had the lowest hidden costs of all the antibiotics studied. The total antibiotic cost of low dosage ceftriaxone (1 g per dose) was comparable with that of cefuroxime, and was substantially less than the costs of cefotaxime and ceftazidime. At the high ceftriaxone dosage (2g per dose), the total antibiotic cost of cefuroxime was less than that of ceftriaxone; however, the total antibiotic cost of ceftriaxone remained substantially less than that of cefotaxime or ceftazidime.     

5种方案治疗小儿肺炎的成本-效果分析

目的:评价5种方案治疗小儿肺炎的经济性。方法:采用回顾性研究和成本-效果分析方法,对阿莫西林钠/克拉维酸钾(A组)、头孢噻肟钠(B组)、头孢哌酮钠/舒巴坦钠(C组)、头孢呋辛钠(D组)、阿奇霉素(E组)治疗小儿肺炎的5种方案进行药物经济学评价。结果:A、B、C、D、E组有效率分别为80.43%、76.09%、65.12%、77.27%、91.30%,成本-效果比分别为1 595.06、1 225.38、1 669.69、1 284.83、697.84。结论:E组方案治疗小儿肺炎较佳。     

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.     

2003-2005年上海市头孢菌素类抗生素不良反应报告分析

目的：通过分析上海市药品不良反应中心收到的药品不良反应（ADR）报告中，头孢菌素类抗生素所致的ADR及其相关因素，了解该类药物ADR发生的情况，以减少ADR的发生。方法：采用回顾性调查方法对2003年6月-2005年2月上海市药品不良反应中心收到的头孢菌素类抗生素所致1333例ADR报告进行统计分析。结果：ADR涉及药品排前3位的是头孢噻肟、头孢拉定和头孢曲松。ADR累及系统以皮肤及其附件损害为最多。结论：应用头孢菌素类抗生索时应关注其ADR，提高安全用药水平。     

儿童专科医院头孢菌素类药物皮肤试验管理实践效果分析

目的探讨儿童专科医院病儿开展头孢菌素类药物皮肤试验的规范化管理和成效。方法回顾性分析 2019年 3月至 2020年 2月和 2020年 6月至 2021年 5月青岛市妇女儿童医院取消头孢菌素类药物常规皮试(仅保留说明书要求的头孢噻肟、头孢美唑皮试)前后,儿童病人头孢菌素类药物使用数据、药品不良反应情况以及抗菌药物使用强度、病人次均药品费用等指标变化情况,并对儿童病人皮试成本进行分析。结果头孢菌素皮试人次明显下降;保留常规皮试的头孢美唑、头孢噻肟消耗量降幅为 6.58%、4.73%,取消常规皮试的药物中头孢曲松消耗量增幅最高为 8.30%;各类头孢菌素药品不良反应(ADR)报告发生率均有提高( P<0.05);取消头孢菌素皮试前后,头孢噻肟、头孢美唑与其他头孢菌素类药物间 ADR发生率相比,均差异无统计学意义;住院儿童皮试抗菌药物使用强度由 1.27 DDDs下降至 0.55 DDDs;门急诊、住院病儿次均皮试药品费用平均下降 1.00元、 10.41元;头孢菌素皮试总成本下降 80.87%。结论取消儿童病人常规头孢菌素皮肤试验后,有利于降低病人用药负担,减少抗菌药物使用的同时有效保证医疗质量与安全。     

In vitro activities of cefepime versus cefotaxime and ceftriaxone against penicillin-resistant Streptococcus pneumoniae determined by Etest

The Etest was used for determining in vitro susceptibilities of 144 unique clinical isolates of penicillin-intermediate and resistant Streptococcus pneumoniae to cefepime, cefotaxime, and ceftriaxone. MIC ranges were 0.12-8 mug/ml for cefepime and 0.06-16 mug/ml for cefotaxime and ceftriaxone. MICs for 50% of the isolates for the three agents were equivalent at 1 mug/ml, whereas MICs for 90% of the isolates were 2 mug/ml for cefotaxime and ceftriaxone, versus 4 mug/ml for cefepime. The Etest is a practical means for determining susceptibilities of S. pneumoniae to cefepime and other cephalosporins in diagnostic laboratories.