氨基糖甙类抗生素的临床决策分析

Clinical decision analysis of aminoglycosides

本文采用决策分析的方法,以抗菌活性,不良反应和治疗代价为主要评价标准,对庆大霉素、丁胺卡那霉素、妥布霉素、西梭霉素和乙基西梭霉素等五种氨基甙类抗生素的临床实用价值进行比较。结果表明:丁胺卡那霉素以其抗菌活性强为特点可供首选。决策分析系统为临床安全、有效和经济的使用药物提供了一种综合性的定量分析方法。

Clinical evalution of gentamycin,amikacin,tobramycin,sisomicin and netilmicin using the decision analysis model is de-scribed.The spectrum of activity including the MIC_(90) and sensitivity rates of the enteric gram—negative bacilli,pseudomonasaeruginosa and penicillinase—producting staphyloccus aureus strains for these aminoglycosides,the adverse effects including thekidney damage,ototoxicity and anaphylactic shock,and the financial cost including the cost of therapy per day and dosing inter-val were used to determine ranking scores for each drug as evaluation criteria.Total scores were determined by multiplyingranking scores by the assigned priority weights(as percentages of 100)for the criteria.The highest—scoring drug were selectedfor Clinical remedies.The result showed that amikacin(U=58.3)was first choice in the aminoglycosides,while the clinicalimportance of sisomicin etc were falling off.Using decision analysis for drug clinical evaluation may promote rational drugtherapy and achieve cost savings.