羟氨苄青霉素联合克拉维酸体外抗菌活性和治疗急性呼吸道感染的药物经济学分析

目的 探讨羟氨苄青霉素 克拉维酸(安奇)的体外抗菌活性并对其治疗急性呼吸道感染的疗效与成本进行评价。方法 体外测定羟氨苄青霉素 克拉维酸对常见致病菌的最低抑菌浓度(MIC)、最小杀菌浓度(MBC)和杀菌曲线,并和同类不含β—内酰胺酶抑制剂抗生素进行比较。将80例临床诊断为呼吸道感染的患儿,随机分为安奇静脉注射、安奇静脉—口服序贯疗法、凯兰欣静脉注射、西力欣静脉注射4组,观察临床疗效并进行成本—效果分析。结果 安奇对140株实验菌的MIC和MBC值及杀菌曲线结果优于同类不含β—内酰胺酶抑制剂抗生素,安奇对多种致病菌的抗菌效果优于益萨林、先锋5、西力欣、头孢曲松,特别是对产超广谱β—内酰胺酶(ESBLs)肺炎克雷伯菌和大肠埃希菌效果更为明显。序贯疗法成本—效果比明显小与其它治疗组。结论 安奇作为羟氨苄青霉素与β—内酰胺酶抑制剂克拉维酸的联合制剂,比现有同类不含β—内酰胺酶抑制剂抗生素具有更广的抗菌谱和更强的抗菌作用,对产ESBLs肺炎克雷伯菌和大肠埃希菌效果有其优势,提示临床在呼吸道感染,特别是产ESBLs革兰阴性杆菌感染时可选用。安奇静脉—口服序贯疗法临床疗效确切,安全、经济方便,值得临床推广。

Evaluation of antibacterial activity of amoxycillin sodium and clavulanate potassium and the pharmacoeconomics in the therapy of acute respiratory infection

OBJECTIVE: To explore the antibacterial activity of amoxycillin sodium and clavulanate potassium (trade name: Anqi) in vitro and the pharmacoeconomics in the therapy of acute respiratory infection. METHODS: Minimal inhibition concentration (MIC), minimal bactericidal concentration (MBC) and bactericidal curve of amoxycillin sodium and clavulanate potassium against common pathogens were determined and compared with some other same kind of antibiotics without beta-Lactamase inhibitor. Eighty cases diagnosed as respiratory infection were randomly divided into 4 groups: group 1 was treated with i.v. Anqi; group 2 was treated with i.v. Anqi and oral consecutive strategy; group 3 was treated with iv ampicillin and sulbactam; group 4 was treated with i.v. cefuroxime. The clinical therapeutic effects were observed and cost-effectiveness analyzed. RESULTS: In terms of MIC, MBC and bactericidal curve of 135 bacterial strains, Anqi was superior to the other same-kind antibiotics without beta-lactamase inhibitor, this effect was especially obvious on Klebsiella pneumoniae and Escherichia coli which can produce extended spectrum beta-lactamases (ESBLs). The cost-effectiveness of the consecutive therapy group was the best. CONCLUSION: Anqi has a wide antimicrobial spectrum and strong effect on the bacteria producing ESBLs, the consecutive therapy strategy should be clinically recommended.