3种常用抗菌药物治疗儿童社区获得性肺炎的成本-效果分析

Cost-effectiveness Analysis of Three Kinds of Commonly Used Antimicrobial agents in The Treatment of Pediatric Community-acquired Pneumonia

目的利用药物经济学方法对3种常用抗菌药物治疗儿童社区获得性肺炎(CAP)方案进行评价,以供临床合理使用药品。方法根据使用的抗菌药物不同,将四川省德阳市德阳第五医院2015年6月至2016年6月收治的84例儿童CAP住院患者分为3组,依次为头孢他啶组(A组),27例;头孢唑肟组(B组),22例;美洛西林钠舒巴坦钠组(C组),35例。观察各组患者的临床疗效及不良反应,采用成本-效果分析法,同时引入决策树模型,对3种治疗方案进行药物经济学评价。结果 A、B、C组患者的总有效率分别为88.89%、63.64%、77.14%;总治疗成本分别为577.49、811.78、758.95元;成本/效果比(C/E)分别为6.50、12.76、9.84;以最小成本的A组为参考计算B组和C组的增量成本-效果比(△C/△E)分别为-9.28%和-15.44%。其中,A组成本最低,C/E最小,敏感度分析结果与成本-效果分析结果一致。结论 3种抗菌药物治疗方案中,头孢他啶更具成本-效果优势,为治疗儿童CAP的首选。

Objective To evaluate the pharmacoeconomics of Three kinds of commonly used antimicrobial agents in the treatment of pediatric community-acquired pneumonia（CAP）, and to provide reference for rational drug use in the clinic.Methods According to the use of antibiotics,84 cases of children CAP the fifth hospital of Deyang city of Deyang province in Sichuan from June 2015 to June 2016 were hospitalized patients were divided into 3 groups, ceftazidime group（A group）,27 cases;ceftizoxime group （B group）,22 cases;mezlocillin sodium sulbactam sodium （Group in group C,35 cases）.To observe the clinical efficacy and adverse reactions of the patients in each group.The cost-effectiveness analysis and the decision tree model were used to evaluate the 3 Therapeutic Schemes.Results The total effective rate of group A, B, C were 88.89%, 63.64%, 77.14%,respectively;The total costs were 577.49 yuan, 811.78 yuan, 758.95 yuan,respectively; The cost-effectiveness ratios were 6.50, 12.76, 9.84, respectively; incremental cost-effectiveness ratio were -9.28% and -15.44% by using the group A as a reference.Results of sensitivity analysis matched results of cost-effectiveness analysis.Conclusion ceftazidime is the best treatment for pediatric community-acquired pneumonia among the three kinds of commonly used antimicrobial agents in respect of cost-effectiveness and should be the first choice of CAP for children.