不同头孢菌素类抗菌药物预防剖宫产术感染的经济学研究

Pharmacoeconomic Study on Different Cephalosporins in Preventing Cesarean Section Infection

目的:评价四种头孢菌素类抗菌药物预防剖宫产术感染的成本-效果,以寻求一种经济有效的方案,减轻患者经济负担,节约医药资源。方法:回顾性选取2016年1月至2018年12月九江市妇幼保健院收治的行剖宫产术患者600例,按照应用抗菌药物品种不同进行分组。A组134例患者采用头孢噻肟钠预防感染,B组102例患者采用头孢唑林钠预防感染,C组186例患者采用头孢呋辛钠(进口)预防感染,D组178例患者采用头孢呋辛钠(国产)预防感染。比较四组患者剖宫产术后预防感染的效果,并进行成本-效果分析。结果:A、B、C及D组患者预防剖宫产术感染有效率分别为97.76%(131/134)、96.08%(98/102)、97.31%(181/186)及96.63%(172/178),预防感染的效果相当,差异无统计学意义(P>0.05)。以住院总费用作为成本,A、B、C及D组方案的成本-效果比分别84.90、69.73、77.69及50.39;以抗菌药物费用作为成本,A、B、C及D组方案的成本-效果比分别为5.31、0.65、2.63及0.39;D组方案的成本-效果比最小。敏感性分析结果与成本-效果分析结果一致。结论:四组方案均可有效预防剖宫产术感染,但D组方案的药物经济学效果最佳,其次为B组;国产与进口的头孢呋辛钠用于预防剖宫产术感染的效果相当。

OBJECTIVE:To evaluate the cost-effectiveness of four kinds of cephalosporins in prevention cesarean section infection,so as to find an economical and effective scheme to reduce patients’economical burden and save medical resources.METHODS:600 patients undergoing cesarean section admitted into Jiujiang Maternal and Child Health Hospital from Jan.2016 to Dec.2018 were selected and divided into four groups according to different antibiotics.Group A(134 cases)was given cefotaxime sodium for infection prevention,group B(102 cases)was given cefazolin sodium,group C(186 cases)was given cefuroxime sodium(imported)and group D(178 cases)was given cefuroxime sodium(domestic).The effect of infection prevention after cesarean section among four groups were compared,and the cost-effectiveness analysis was conducted.RESULTS:The effective rate of infection prevention of cesarean section of group A,group B,group C and group D were respectively 97.76%(131/134),96.08%(98/102),97.31%(181/186)and 96.63%(172/178),with similar effect,the differences had no statistical significance(P>0.05).To set total hospitalization expenses as the cost,the cost-effectiveness ratio of group A,group B,group C and group D were respectively 84.90,69.73,77.69 and 50.39;while to set antibacterial expenses as the cost,the cost-effectiveness ratio of group A,group B,group C and group D were respectively 5.31,0.65,2.63 and0.39;the cost-effectiveness ratio of the group D was the smallest.The result of sensitivity analysis was consistent with that of cost-effectiveness analysis.CONCLUSIONS:All the four schemes can effectively prevent cesarean section infection,but group D has the best pharmacoeconomic effect,followed by group B;domestic cefuroxime sodium has similar effect in preventing cesarean section infection as the imported.