阿莫西林-克拉维酸序贯治疗社区获得性下呼吸道感染成本-效果分析

目的 :评价阿莫西林 克拉维酸针剂静脉滴注与片剂口服序贯治疗急性社区获得性中度下呼吸道细菌感染的疗效、安全性及成本效果。方法 :采用多中心区组随机化 ,平行对照实验设计。A组 30例 ,阿莫西林 克拉维酸注射液 2 .4 g,iv ,gtt ,bid×10d ;B组 30例 ,先用阿莫西林 克拉维酸注射液2 .4 g,iv ,gtt ,bid× 5d后 ,改为阿莫西林 克拉维酸片 0 .6 2 5 g ,po ,tid× 5d ,总疗程 10d。结果 :A ,B两组一般资料统计学比较无差异 ,临床有效率分别为 83%和 80 % ,细菌清除率为 71%和 6 9% (P >0 .0 5 )。 2组总医疗费分别为 (3782±s 396 )元和(2 6 33± 2 6 8)元 ,成本 效果比为 4 5 5 6± 4 77和32 91± 35 5 ,且B组住院日数明显缩短 (P <0 .0 1)。2组的不良反应率相似。结论 :阿莫西林 克拉维酸针剂静脉滴注与片剂口服序贯治疗 ,治疗急性社区获得性中度下呼吸道细菌感染与持续静脉滴注有相似的临床和细菌学疗效 ,但可明显缩短住院日数 ,并有更好的成本 效果比。

Cost-effectiveness analysis of amoxicillin/clavulanic acid sequential therapy in treating acute community-ac-quired low respiratory tract infections

AIM: To evaluate the efficacy, safety and cost-effectiveness of amoxicillin/clavulanate sequential therapy in treating acute community-acquired low respiratory tract infections. METHODS: This was a multi-center, block randomized, parallel controlled clinical study. Sixty patients with acute community-acquired low respiratory tract infection were randomly divided into two groups. Thirty patients of group A received amoxicillin/clavulanate injection 2.4 g, iv, gtt, bid for 10 d. Thirty patients of group B received sequential therapy which composed of amoxicillin/clavulanate injection 2.4 g, iv, gtt, bid for 5 d then 0.625 g, po, tid for 5 d. The efficacy, bacterial eradication rate, hospital costs and adverse reactions of the two groups were observed. RESULTS: The effective rates of the two groups were 83 % and 80 %, respectively (P>0.01). Total medical expense in group A was RMB (3 782±s 396) YUAN and RMB (2 633±268) YUAN in group B, but there was less admission days in group B. Compared the cost-effectiveness rate, they were RMB(4 556±477) YUAN and RMB(3 291±355)YUAN. There was significant difference between two groups (P<0.01). The adverse reaction rates of two groups were similar. No dysfunction in hepatic or urinary system was found in both groups. CONCLUSION: Sequential therapy of amoxicillin/clavulanate injection and tablet has the same clinical and antibacterial effects in treating acute community-acquired low respiratory tract infection as using amoxicillin/clavulanate injection alone has. But the former can reduce admission days and improve cost-effectiveness rate.