阿奇霉素治疗肺炎支原体肺炎的成本-效果分析

Cost-Effectiveness of Azithromycin in the Treatment of Mycoplasma Pneumoniae Pneumonia

目的:运用药物经济学分析方法,探讨阿奇霉素序贯疗法、阿奇霉素-米诺环素转换疗法治疗肺炎支原体肺炎的最佳药物治疗方案,以最低成本获得最佳效果。方法:回顾性选取2016年8月至2018年12月该院儿科收治的8岁以上肺炎支原体肺炎患儿322例,根据治疗方案分为A组(阿奇霉素序贯治疗)160例和B组(阿奇霉素-米诺环素转换疗法)162例。通过决策树及SPSS软件,对两组方案进行成本-效果分析。结果:A组患儿入院后咳嗽好转时间、入院后发热好转时间、入院后肺部体征好转时间和平均住院时间明显长于B组,差异均有统计学意义(P<0.05)。A组、B组患儿的总有效率分别为89.4%(143/160)、92.6%(150/162),差异无统计学意义(P=0.529)。A组、B组每治愈1例肺炎支原体肺炎患儿的成本分别为3840、3570元。两组患儿在治疗过程中均未发现明显不良反应。结果:对于8岁以上肺炎支原体肺炎患儿,阿奇霉素序贯疗法与阿奇霉素-米诺环素替换治疗的效果相当,阿奇霉素-米诺环素替换治疗的成本偏低。

OBJECTIVE:To explore the optimal drug treatment plan of azithromycin sequential therapy and azithromycin-minocycline therapy in the treatment of Mycoplasma pneumoniae pneumonia by using the pharmacoeconomic analysis methods,and obtain the best effect at the lowest cost.METHODS:Retrospective analysis was performed on 322 children with M.pneumoniae pneumonia over 8 years old admitted into pediatrics of the hospital from Aug.2016 to Dec.2018.According to the treatment regimen,all patients were divided into group A(azithromycin sequential therapy)with 160 cases and group B(azithromycin-minocycline therapy)with 162 cases.Through decision tree and SPSS software,cost-effectiveness analysis of two groups was carried out.RESULTS:The improvement time of cough,fever,pulmonary signs and average length of stay in group A were significantly longer than those in group B,with statistically significant differences(P<0.05).The total effective rates in group A and group B were respectively 89.4%(143/160)and 92.6%(150/162),with no statistically significant difference(P=0.529).The curing costs of one case with M.pneumoniae pneumonia in group A and group B were respectively 3840 yuan and 3570 yuan.No obvious adverse drug reactions were found in two groups.CONCLUSIONS:For children with M.pneumoniae pneumonia over 8 years old,there is no significant difference between azithromycin sequential therapy and azithromycin-minocycline therapy,and the cost of azithromycin-minocycline therapy is low.