5种不同头孢菌素对儿童患者支气管肺炎的临床疗效及药物经济学评价

Clinical Efficacy and Pharmacoeconomic Evaluation of 5 Kinds of Different Cephalosporins in Children Patients with Bronchopneumonia

目的:评价5种不同头孢菌素(注射用五水头孢唑林钠、注射用头孢噻肟钠、注射用头孢孟多酯钠、注射用头孢硫脒和注射用头孢呋辛钠)对儿童患者支气管肺炎的临床疗效及药物经济学,为临床用药品种的选择提供参考。方法:抽取住院儿童患者2018年病历,筛查出抗菌药物使用病历中患者的年龄、性别和药物使用、药物不良反应、临床疗效与医疗成本费用;采用成本-效果分析方法,评价5种不同头孢菌素治疗儿童患者支气管肺炎的疗效与成本的药物经济学,找出治疗效果最佳、成本最低的抗菌药物。结果:采用注射用五水头孢唑林钠、注射用头孢噻肟钠、注射用头孢孟多酯钠、注射用头孢硫脒和注射用头孢呋辛钠抗菌药物治疗其支气管肺炎的总有效率分别为90.24%、88.75%、90.91%、87.50%和89.33%;经过χ2检验发现各组总有效率经比较其差异无统计学意义(P>0.05);在达到基本一致的疗效时,注射用五水头孢唑林钠的成本-效果较低,而其他4种抗菌药物成本-效果相对较高。结论:与其他4种头孢菌素比较,采用注射用五水头孢唑林钠治疗儿童患儿支气管肺炎医疗成本-效果占优势,临床在治疗儿童支气管肺炎患者时应优先考虑注射用五水头孢唑林钠治疗。

Objectives:To evaluate the clinical efficacy and pharmacoeconomics of 5 kinds of different cephalosporins(cefazolin sodium for injection,cefotaxime sodium for injection,cefmeningol sodium for injection,cefthiamidine for injection and cefuroxime sodium for injection)in children patients with bronchopneumonia,so as to provide reference for the selection of best clinical drug varieties.Methods:The medical records of hospitalized children in 2018 were selected to screen out the age,gender,drug use,adverse drug reactions,clinical efficacy and medical costs of the patients in the medical records of antimicrobial use.The cost-effectiveness analysis method was used to evaluate the efficacy and cost of 5 kinds of different cephalosporins in the treatment of children patients with bronchopneumonia,and to find out the antibacterial drugs with the best therapeutic effect and the lowest cost.Results:The total effective rates of cefazolin sodium for injection,cefotaxime sodium for injection,cefmeningol sodium for injection,cefthiamidine for injection and cefuroxime sodium for injection were 90.24%,88.75%,90.91%,87.50%and 89.33%,respectively.There was no significant difference in the total effective rate between the two groups byχ2 test(P>0.05).When basically consistent efficacy was achieved,cefazolin sodium pentahydrate had a low cost-effectiveness,while the other 4 kinds of antibacterial drugs had a relatively high cost-effectiveness.Conclusions:Compared with the other 4 kinds of cephalosporins,the cost-effectiveness of cefazolin sodium for injection in the treatment of bronchopneumonia in children is superior,so it should be given priority to treat children with bronchopneumonia by using cefazolin sodium for injection.