集中带量采购阿莫西林与阿莫西林克拉维酸钾根除幽门螺杆菌临床疗效评估

Clinical evaluation of the efficacy against helicobacter pylori by amoxicillin from volume-based procurement and potassium amoxicillin clavulanate

目的:评估集中带量采购(集采)阿莫西林与阿莫西林克拉维酸钾根除幽门螺杆菌(helicobacter pylori,Hp)的疗效,为临床方案选择提供依据。方法:利用合理用药管理系统调取2021年5月至2022年5月接受Hp根除治疗患者的数据,筛选使用阿莫西林方案(集采阿莫西林1.0 g bid+枸橼酸铋钾220 mg bid+艾司奥美拉唑20 mg bid+克拉霉素0.5 g bid,14 d)和阿莫西林克拉维酸钾方案(阿莫西林克拉维酸钾0.914 g bid+枸橼酸铋钾220 mg bid+艾司奥美拉唑20 mg bid+克拉霉素0.5 g bid,14 d)患者的数据,对两方案的疗效进行比较探讨。结果:集采阿莫西林组共收集到171例,根除成功率87.8%(150/171)。阿莫西林克拉维酸钾组共收集到69例,根除成功率76.8%(53/69)。两组患者基线资料差异无显著性(P>0.05)。两组临床疗效存在统计学差异(P<0.05)。阿莫西林方案成本效果比值(C/E)低于阿莫西林克拉维酸钾方案。结论:集采阿莫西林方案根除Hp感染临床疗效优于阿莫西林克拉维酸方案,值得临床推广。

AIM:To evaluate the clinical efficacy of amoxicillin from volume-based procurement(VBP)and potassium amoxicillin clavulanate in the eradication of helicobacter pylori(Hp)infection,providing basis for the selection of treatment programs.METHODS:Data from the patients who received Hp eradication therapy from May 2021 to May 2022 were recruited from the rational drug use management system.The data from the patients treated by amoxicillin(amoxicillin 1.0 g bid+bismuth potassium citrate 220 mg bid+esomeprazole 20 mg bid+clarithromycin 0.5 g bid,for 14 days)and potassium amoxicillin clavulanate(potassium amoxicillin clavulanate 0.914 g bid+bismuth potassium citrate 220 mg bid+esomeprazole 20 mg bid+clarithromycin 0.5 g bid,for 14 days)were selected and compared.RESULTS:A total of 171 cases were collected in the group treated by Amoxicillin program,and the eradication rate was 87.8%(150/171).A total of 69 cases were collected in the group of potassium amoxicillin clavulanate,and the eradication rate was 76.8%(53/69).There was no significant difference in baseline data between the two groups(P>0.05).There was a significant difference in clinical efficacy between the two groups(P<0.05).In addition,the cost-effectiveness ratio(C/E)of the Amoxicillin treatment program was lower than that of the potassium amoxicillin clavulanate program CONCLUSION:The clinical efficacy of VBP Amoxicillin program in eradicating Hp infection is better than that of the potassium amoxicillin clavulanate program,which is worthy of clinical recommendation.