5种抗菌药物对泌尿系统感染患者疗效的成本-效果分析

Cost-effectiveness Analysis for 5 kinds of Antibacterial Agents in Patients with Urinary Tract Infections

目的:分析5种抗菌药物对泌尿系统感染疗效的成本-效果,促进临床合理用药,降低治疗费用。方法:收集2009年12月—2014年2月间赣州市立医院治疗391例泌尿系统感染患者,按照药物的不同治疗方案分为A、B、C、D、E共5组,即A组83例患者给予左氧氟沙星治疗,B组77例患者予加替沙星治疗,C组74例患者予依诺沙星治疗,D组81例患者予氟罗沙星治疗,E组76例患者予环丙沙星治疗;运用药物经济学分析方法评价5种抗菌药物治疗泌尿系统感染疗效的成本-效果。结果:用A、B、C、D、E5组治疗方案的有效率分别为91.57%,84.42%,78.38%,93.83%和61.84%;其细菌清除率分别为88.34%,81.02%,76.27%,90.87%和59.61%;五组疗效的成本-效果比(C/E)分别为2.76,3.51,2.49,5.06和1.21;增量成本-效果比(△C/△E)分别为4.36,7.75,5.62,12.89和7.21;5组治疗方案出现不良反应率分别为9.64%(8例),9.09%(7例),9.46%(7例),9.87%(8例)和9.21%(7例),经比较其差异无统计学意义(P>0.05)。结论:从药物经济学角度分析的5种抗菌药物中,A组(左氧氟沙星)对治疗泌尿系统感染的疗效为最优治疗方案。

Objective： To analyse the cost-effectiveness for 5 kinds of antibacterial agents in patients with urinary tract infections and to promote clinical rational drug use and reduce the cost of treatment. Methods： Collecting 391 cases of patients with urinary system infection treated in Ganzhou Municipal Hospital between December 2009 and February 2014, and dividing into five groups A, B, C, D and E of according to the different drugs treatment. 83 patients of A group were given levofloxacin for treatment, 77 patients of B group were given gatifloxacin for treatment, 74 patients of C group wcre given enoxacin for treatment, 81 patients of D group were given fleroxacin for treatment and 76 patients of E group were given ciprofloxacin for treatment. Five antibacterial agents for treatment of urinary system infection of cost-effectiveness were evaluated by pharmaco-economics analysis method. Results： The effective rates of E five groups A, B, C and D of therapeutic schedule were 91.57%, 84.42%, 78.38%, 93.83% and 61.84%, respectively. And the clcarance rates of pathogens were 88.34%, 81.02%, 76.27%, 90.87% and 59.61%, respectively. The cost-effectivencss ratios （△ C/△ E） of five groups were 2.76, 3.51, 2.49, 5.06 and 1.21, respectively. The cost-effectiveness ratios （△ C/△ E） of five groups respectively were 4.36, 7.75, 5.62, 12.89 and 7.21. The adverse reactions rates of five groups were 9.64%（8 cases）, 9.09%（7 cases）, 9.46%（7 cases）, 9.87%（8 cases） and 9.21%（7 cases）, respectively. By compari- son, thc difference not no statistically significant（P〉0.05）. Conclusion： A along 5 kinds of antibacterial agents with phannacoeconomics, levofloxacin is the optimal schedule for treatment of urinary system infection.