亚胺培南治疗院内常见耐药菌血流感染给药方案结合蒙特卡洛模拟的药物经济学评价

目的 探讨亚胺培南不同给药方案治疗院内常见耐药菌血流感染的经济学效果.方法 调查中山市人民医院2019—2020年应用亚胺培南治疗院内常见耐药菌血流感染病例共151例,按照实际给药分为A方案:0.5 g/次,每12小时给药1次(q12h);B方案:0.5 g/次,每8小时给药1次(q8h);C方案:1 g/次,q12h...

Pharmacoeconomic evaluation of imipenem against hospital common drug-resistant bacteria blood infection based on Monte Carlo simulation

Objective To evaluate the economic effects of different dosage regimens of imipenem against hospital common drug-resistant bacteria blood infection. Methods A total of 151 cases using imipenem against hospital common drug-resistant bacteria blood infection were investigated in Zhongshan City People''s Hospital from 2019 to 2020 were divided into 5 groups according to actual dosage regimens. group A (0.5 g, q12h), group B (0.5 g, q8h), group C (1 g, q12h), group D (1 g, q8h) and group E (1 g, q6h). These dosage regimens were evaluated with Monte Carlo simulation (MCS), caluated for cumulative fraction responses (CFR), and conducted cost-effectiveness analysis (CEA) respectively. Results the C/E values of the 5 groups were 68.5, 68.2, 100.4, 82.6 and 93.1 respectively. Taking A regimen as the reference, the incremental cost effectiveness ratio(∆C/∆E) of other 4 regimens were 65.9, 845.1, 147.2, and 201.8 respectively. Conclusion Regimen B with the least C/E value had poor antibacterial activity against multi-drug resistant Acinetobacter baumannii (MDR-AB), carbapenem resistant Pseudomonas aeruginosa (CRPA) and carbapenem resistant enterobacteriaceae (CRE), which is not the best regimen for the hospital common drug-resistant bacteria blood infection. Dosage regimen should be selected combinating with clinical drug resistant strains. Regimen D is more effective than regimen C and regimen E, and regimen E with more administration frequency does not show higher benefit.