利复星静脉与片剂序贯治疗中度下呼吸道感染疗效和成本效益分析

The efficacy and safety of domestic levofloxacin injecti on and tablet in treatment of moderate bacterial infection

目的 :进一步讨论“利复星 (左旋氧氟沙星 )针剂静脉滴注 片剂口服序贯治疗”对中度社区肺部细菌感染的疗效、安全性及卫生经济学的综合评价。方法 :采用区组随机化、多中心平行对照试验设计。A组用利复星2 0 0mg ,静脉滴注 ,bid ;B组先用利复星注射液 2 0 0mL静脉滴注 ,bid ,连续 4d后 ,改为利复星 2 0 0mg ,po ,bid。总疗程均为l0～ 14d。结果 :2组总有效率分别为 86.79%和 84 .91% ,统计学上无显著性差异 (P >0 .0 5 ) ,2组细菌清除率分别为 77.78%和 76.0 0 % ,统计学上无显著性差异 (P >0 .0 5 )。 2组的不良反应均相似 ,且很低 ,未见引起肝、肾功能异常改变。在药物经济学上 ,B组各项指标均占优势 ,住院天数明显缩短 ,住院费用分别为 5 65 .5 3和 3 95 .3 0元 ,总医疗费分别为 3 812 .3 8和 2 4 5 2 .67元。成本 效果比 ,2组分别为 4 3 94和 2 889元 ,经统计学分析 ,均有显著性差异 (P <0 .0 1)。结论 :利复星具有良好的药代动力学和安全性 ,抗菌谱广 ,疗效显著 ,利复星针剂静脉滴注 片剂口服序贯治疗呼吸系统中度细菌性感染 ,是一种理想、成本效果上佳的治疗方案。

Objective:To evaluate the efficacy and safety of dom estic levofloxacin injection and tablet in treating moderate bacterial infectio n.Methods:106 patients with moderate bacterial infection were randomly divided into 2 groups:group A received domestic levofloxacin,iv,drip 200mg bid for (10～)14 days,and group B(sequential therapy group)received levofloxacin,iv, drip 200mg bid for 4 days then followed by levofloxacin tablets 200mg bid orally for 7～10 days.Results:The clinical efficacy rate was 86.79% in group A and 84.91% in group B,while bacterial clearance was 77.78% and 76.00% respectively,without si gnificant difference (P>0.05).The adverse reaction incidences were mild and low in both groups.But the cost/efficacy ratio in group B was higher than group A,because of the shorter hospitalization and lower medical expenditure (P<0. 01).Conclusion:The domestic levofloxacin was effective and safe in treating moderate bacterial infection.And sequential antibiotic therapy of levofloxacin was more economic in clinical use.