序贯联合治疗社区获得性肺炎的临床疗效和经济效果

Clinical Efficacy and Economic Effect of Amoxicillin and Clavulanate Potassium Granules Combined with Levofloxacin Hydrochloride for Sequential Therapy of Community Acquired Pneumonia

目的探讨阿莫西林克拉维酸钾序贯联合左氧氟沙星治疗社区获得性肺炎的临床疗效、安全性及经济效果。方法将80例社区获得性肺炎患者随机分成观察组和对照组各40例,观察组给予阿莫西林克拉维酸钾1.2g,静脉滴注,2次/d,连续3d,继而口服阿莫西林克拉维酸钾375mg,2次/d,联合口服盐酸左氧氟沙星胶囊,500mg/d;对照组给予阿莫西林克拉维酸钾1.2g静滴,2次/d,联合口服盐酸左氧氟沙星胶囊,500mg/d;疗程7～14d。比较两组患者的临床疗效和经济效果。结果观察组和对照组总有效率分别为92.50%和90.00%,细菌总清除率分别为91.43%和87.88%,不良反应发生率分别为5.00%和5.00%,两者比较差异无统计学意义(P>0.05)。但是,观察组的成本-效果比低于对照组(P<0.05)。结论阿莫西林克拉维酸钾序贯联合左氧氟沙星治疗社区获得性肺炎,具有安全、有效、方便等特点,显著降低了总医疗费用,值得临床推广应用。

Objective To explore the safety, clinical efficacy and economic effect of amoxicillin and clavulanate potassium granules combined with levofloxacin hydrochloride for sequential therapy of community acquired pneumonia （ CAP ）. Methods Eighty cases patients with community acquired pneumonia were randomly divided into the intervention group （ 40 cases ） and control group （ 40 cases ）. The intervention group was treated with IV injection of amoxicillin and clavulanate potassium granules 1.2 g, twice daily, for 3 days, then took 375mg, twice daily; Combined with oral levofloxacin hydrochloride capsules, 500 mg/d. The control group was treated with IV injection of amoxicillin and clavulanate potassium granules 1.2g, twice daily. Combined with oral levofloxacin hydrochloride capsules, 500mg/d for 7 to 14 days, then the clinical and economic effects of two groups were observed respectively before and after treatment. Results The overall effective rates of intervention group and control group were 92.50% and 90.00% respectively, the eradication rates of pathogens were 91.43% and 87.88% respectively, the rates of side effects were 5.00% and 5.00% respectively, and there was no significant difference between two groups （ P 〉 0.05 ）. But cost-effectiveness ratio in intervention group was lower than that in control group （P 〈 0.05 ）. Conclusion The sequential therapy of amoxicillin and clavulanate potassium granules combined with levofloxacin hydrochloride is safe, effective and handy in the treatment of patients with community acquired pneumonia, obviously decreases total medical cost, and hence is worthy of being recommended in clinical practice.