Pharmacoeconomic evaluation of different dosing regimens of levofloxacin treating the bacterial infections of lower respiratory tract
-
摘要: 目的 对左氧氟沙星两种不同给药方案治疗下呼吸道细菌性感染进行药物经济学评价,为临床选择安全、有效、经济的治疗方案提供依据。 方法 将108例下呼吸道细菌性感染患者随机均分为静注组和序贯组,静注组采用左氧氟沙星注射液连续静脉滴注;序贯组先采用左氧氟沙星注射液静脉滴注,后继以左氧氟沙星胶囊口服进行序贯治疗,两组总疗程均为7~14 d,两组用药总天数相同,运用最小成本分析法进行分析。 结果 静注组的人均总成本(1 779.80±304.15)元,显著高于序贯组(1 290.85±173.76)元;两组每获得1个单位疗效需分别花费34.89元和14.52元,序贯组和静注组之间效果差异的单位成本为264.3元;两组痊愈率分别为72.22%和62.96%(P>0.05),总有效率分别为90.74%和88.89%(P>0.05),细菌清除率分别为86.96%和84.44%(P>0.05),不良反应发生率分别为9.26%和7.41%(P>0.05)。 结论 左氧氟沙星序贯治疗下呼吸道细菌性感染是一种安全、有效、经济的治疗方案,较持续静脉输注更具成本-效果优势,从药物经济学层面考虑值得推广使用。Abstract: Objective To evaluate the pharmacoeconomics of two different dosing regimens of levofloxacin treating the bacterial infections of lower respiratory tract, and provide the basis for selecting the security, effective and economic treatment programs clinically. Methods The 108 patients with bacterial infections of lower respiratory tract were divided into the intravenous group and sequential group randomly, the intravenous group used levofloxacin for the intravenous infusion and the sequential group firstly for the intravenous infusion and then for the oral levofloxacin capsule, and the total treatment course of two groups were 7-14 days, and the days of drug use of the two groups should be same so as to conduct the minimal cost analysis for the above two programs. Results The total cost per one patient of the intravenous group (1 779.80±304.15 yuan) was higher than the sequential group(1 290.85±173.76 yuan) significantly, treatment unit of each group needed cost 34.89 yuan and 14.52 yuan respectively. Compared with the sequential group, the intravenous group needed spend more 264.3 yuan.The recovery rate of the two groups was 72.22% and 62.96% respectively(P>0.05), the total effective rate of the two groups was 90.74% and 88.89% respectively(P>0.05), the clearance rate of bacteria of the two groups was 86.96% and 84.44% respectively(P>0.05), and the incidence of adverse reactions was 9.26% and 7.41% respectively(P>0.05). Conclusion The sequential therapy of levofloxacin was a security, effective and economic treatment program, compared with the continuous infusion, and had a more cost-effective advantages, which should be popularized from the consideration of the pharmacoeconomics level.
-
[1] 周元瑶.药物流行病学[M].北京:中国医药科技出版社,1996:81. [2] 王全洪,何 勇,王玉和.莫西沙星注射液与左氧氟沙星注射液随机对照治疗社区获得性肺炎药物经济学评价[J].中国药物经济学,2013,8(3):36-39. [3] Marrie TJ,Lau CY,Wheeler SL, et al.A controlled trial of a critical pathway for treatment of community-acquired pneumonia[J].JAMA, 2000, 283(6):749-755. [4] Vogel F. Intravenous/oral sequential therapy in patients hospitalised with community-acquired pneumonia:which patients,when and what agents?[J].Drugs,2002,62(2):309-317. [5] 陈丽娟,钱红玉.左氧氟沙星序贯治疗老年急性下呼吸道感染的药物经济学研究[J].中国药房,2007,18(17):1298-1299. [6] 赵志刚,李 晔,陈 旭.药物经济学的研究方法及应用[J].中国医药导刊,1999,1(2):49-52. [7] 谢红光,周宏灏.药物经济学的基本理论与方法[J].药物流行病学杂志,1995,4(1):1-4. [8] 王玉和,黎俊华.头孢甲肟与头孢哌酮治疗急性细菌性感染的药物经济学分析[J].中国新药杂志,2006,15(10):830-832. [9] 孙晓东.药物经济学的概论、方法和应用[J].国外医学·药学分册,1994,21(1):13-15. [10] 胡善联.敏感度分析[J].卫生经济研究,2000,17(1):36-38. [11] 张大禄,翟红旗,袁少东.抗菌药物序贯疗法推广的必要性与可行性[J].中国医院药学杂志,2001,21(3):31-33. [12] 孙忠实,朱 珠,张素敏.大力提倡抗微生物的转换疗法[J].中国药学杂志,1999,34(10): 63-64. [13] 刘如品,杨秀霞,王 强,等.左氧氟沙星序贯疗法治疗下呼吸道细菌性感染的成本-效果分析[J].中国医院用药评价与分析,2004,4(5):292-293. [14] 刘 卫,凌宙贵,汪春梅.左氧氟沙星序贯疗法治疗成人社区获得性肺炎112例临床疗效观察[J].中华实用诊断与治疗杂志,2008,22(9):718-719. [15] 宋 敏.左氧氟沙星治疗下呼吸道感染的药物经济学评价[J].医药论坛杂志,2006,27(9):78-81. [16] 陈丽娟,钱红玉.左氧氟沙星序贯治疗老年急性下呼吸道感染的药物经济学研究[J].中国药房,2007,18(17):1298-1299. [17] Siegel RE, Halpern NA. Almenoff PL, et al. A prospective randomized study of inpatient intravenous antibiotics for community-acquired pneumonia: the optiomal duration of therapy[J].Chest,1996,110(4):965-971. [18] Niederman MS,Bass JB Jr,Campbel GD, et al.Guidelines for the initial management of adults with community-acquired pneumonia: diagnosis, assessment of severity, and inital antimicrobial therapy[J].Am Rev Respir Dis,1993,148(5):1418-1426. [19] 杨 帆,焦红梅,张婴元,等.左氧氟沙星治疗细菌性感染70例[J].中国新药与临床杂志,1998,17(2):6-8. [20] Cunha BA. Community-acquired pneumonia.Cost-effective antimicrobial therapy[J].Postgrad Med, 1996,99(1):113-119. [21] Ramirez JA, Srinath L, Ahkes S, et al. Early switch from intravenous to oral cephalosporins in the treatment of hospitalized patients with community-acquired pneumonia[J].Arch Intern Med,1995,155(12):1273-1276.
计量
- 文章访问数: 3568
- HTML全文浏览量: 221
- PDF下载量: 350
- 被引次数: 0