5种抗菌药物治疗儿童支气管肺炎的药物经济学评价

Pharmacoeconomics Evaluation of 5 Kinds of Antibiotics in the Treatment of Pediatric Bronchopneumonia

目的:对头孢硫脒、头孢曲松钠、头孢呋辛钠、阿莫西林钠克拉维酸钾和头孢哌酮钠舒巴坦钠治疗儿童支气管肺炎的方案进行药物经济学评价,为临床合理用药提供参考。方法:采用回顾性研究方法,将338例支气管肺炎患儿根据用药方案不同分为A(75例)、B(65例)、C(76例)、D(66例)、E(56例)组,分别对应使用头孢硫脒、头孢曲松钠、头孢呋辛钠、阿莫西林钠克拉维酸钾、头孢哌酮钠舒巴坦钠进行静脉滴注。采用成本-效果分析法并引入决策树模型,对5种治疗方案进行药物经济学评价。结果:A、B、C、D、E组的有效率分别为93.33%、90.77%、96.05%、87.88%、87.50%,总治疗成本分别为1 929.09、2 173.73、1 611.91、1 661.42、1 801.32元,成本/效果比(C/E)分别为20.67、23.95、16.78、18.91、20.59。其中,C组治疗方案的成本最低、C/E最小。敏感度分析支持成本-效果分析结果。结论:在上述5种抗菌药物治疗方案中,头孢呋辛钠治疗儿童支气管肺炎更具成本-效果优势。

OBJECTIVE： To evaluate the pharmacoeconomics of cefathiamidine, ceftriaxone sodium, cefiaroxime sodium, amoxicillin sodium/clavulanate potassium and cefoperazone sodium/sulbactam sodium in the treatment of pediatric bronchopneumo- nia, and to provide reference for rational drug use in the clinic. METHODS： By retrospective study, 338 children with broncho- pneumonia were divided into groups A, B, C, D and E according to different therapy regimens. There were 75, 65, 76, 66 and 56 cases in groups A, B, C, D and E, and they were given cefathiamidine, ceftriaxone sodium, cefuroxime sodium, amoxicillin sodium/clavulanate potassium and cefoperazone sodium/sulbactam sodium intravenously. The pharmacoeconomics of therapy regi- mens in group A, B, C, D and E were evaluated by cost-effectiveness analysis and decision tree analysis model. RESULTS： The effective rates of groups A, B, C, D and E were 93.33%, 90.77%, 96.05%, 87.88% and 87.50%, respectively. The treatment cost of those groups were 1 929.09, 2 173.73, 1 611.91, 1 661.42, 1 801.32 yuan, respectively. The cost/effectiveness （C/E） ratio of those groups were 20.67, 23.95, 16.78, 18.91, 20.59, respectively. The treatment cost of group C was the smallest, so was the C/E. Results of cost-effectiveness analysis were supported by sensitivity analysis. CONCLUSIONS： Cefuroxime sodium is the best treatment for pediatric bronchopneumonia among 5 antibiotics in respect of cost-effectiveness.