不同喹诺酮类抗菌药治疗社区获得性肺炎的药物经济学评价

Pharmacoeconomics evaluation on quinolone antibacterials in the treatment of community acquired pneumonia

目的对比不同喹诺酮类抗菌药治疗社区获得性肺炎(community acquired pneumonia,CAP)的临床效果,并应用药物经济学原理分析药物成本-效果(C/E)。方法选择2012年7月至2014年7月于本院接受治疗的CAP患者160例为研究对象,按入院先后顺序分为A、B、C、D组,每组各40例。A组患者给予乳酸左氧氟沙星氯化钠注射液,B组患者给予盐酸洛美沙星氯化钠注射液,C组患者给予加替沙星氯化钠注射液,D组患者给予盐酸莫西沙星氯化钠注射液,疗程均为7天,结束后比较四组疗效并分析C/E。结果 A组总有效率为82.50%(33/40),B组为85.00%(34/40),C组为95.00%(38/40),D组为95.00%(38/40),四组比较差异均无显著性(P>0.05)。A组C/E最低,为4.68,B组为5.35,C组为5.48,D组最高,为21.58,A、B、C、D组的药物C/E依次升高,差异具有显著性(P<0.05)。A、B、C、D组患者的敏感度依次升高,差异具有显著性(P<0.05)。结论左氧氟沙星注射液治疗CAP的C/E最低,具有更高的药物经济学价值;加替沙星ΔC/ΔE最低,是最佳的替代选择。

Objective To compare the clinical efficacy of different quinolone antibiotic in the treatment of community acquired pneumonia（CAP）, and analyze cost-effectiveness（C/E） by applying the principles of pharmacoeconomics. Method 160 patients with CAP treated in our hospital from July 2012 to July 2014 were selected and divided into A, B, C, D group according to the admission sequence, 40 cases in each group. Group A were treated with levofloxacin lactate and sodium chloride injection, group B were treated with lomefloxacin hydrochloride and sodium chloride injection, group C were treated with gatifloxacin gatifloxacin sodium chloride injection, group D were treated with moxifloxacin hydrochloride and sodium chloride injection, treatment lasted 7 days, at the end the efficacy of disease C/E of 4 groups were analyzed. Result The total effective rate of group A was 82.50%（33/40）, group B was 85.00%（34/40）, group C was 95.00%（38/40）, group D was 95.00%（38/40）, the differences were not significant（P〉0.05）. C/E of group A was the lowest, 4.68, group B was 5.35. Group C was 5.48, group D was the highest, 21.58, the costeffectiveness of group A, group B, group C, group D increased successively, the difference was significant（P〈0.05）. The sensitivity of group A, B, C and D were increased, and the difference was significant（P〈0.05）. Conclusion The C/E of levofloxacin injection in the treatment of CAP is the minimum, it has a higher pharmacoeconomics value; the ΔC/ΔE of gatifloxacin is the lowest, it is the best alternative.