摘要
目的:对比莫西沙星单用与哌拉西林他唑巴坦联合阿奇霉素治疗老年社区获得性肺炎(CAP)的临床效果、不良反应与成本。方法:采用回顾性研究法,选取某"三甲"医院呼吸内科2015年10月-2016年4月收治的老年CAP住院患者60例,按给药方案不同分为A、B组,各30例。A组患者给予盐酸莫西沙星氯化钠注射液250 m L,ivgtt,qd;B组患者给予注射用乳糖酸阿奇霉素0.50 g,ivgtt,qd+注射用哌拉西林钠他唑巴坦钠3.375 g,ivgtt,q8 h。两组疗程均为10 d。比较两组患者的临床疗效、细菌学疗效及不良反应发生情况,并评价两种药物方案的经济性。结果:A、B组患者的临床总有效率分别为90.00%、93.33%,细菌清除率分别为85.00%、86.36%,不良反应发生率分别为3.33%、6.67%,两组比较差异均无统计学意义(P>0.05)。故采用最小成本分析法进行经济学评价,可得A组的治疗成本为16 646.51元,B组为19 605.74元,A组成本低于B组;敏感度分析支持最小成本分析结果。结论:老年CAP住院患者在使用抗菌药物进行经验性治疗时,宜首选莫西沙星单用,该方案疗效确切、花费较低、安全性较高。
OBJECTIVE：To compare clinical efficacy,ADR and cost of moxifloxacin alone vs. piperacillin/tazobactam combined with azithromycin in the treatment of elderly community acquired pneumonia（CAP）. METHODS：In retrospective study,60 elderly CAP patients were selected from respiratory department of a third grade Class A hospital during Oct. 2015-Apr. 2016,and then divided into group A,B with 30 cases in each group according to the medication regimen. Group A was given Moxifloxacin hydrochloride and sodium chloride injection 250 m L,ivgtt,qd;group B was given Azithromycin latobionate for injection 0.50 g,ivgtt,qd＋Piperacillin sodium and tazobactam sodium for injection 3.375 g,ivgtt,q8 h. Both groups were treated for 10 d. Clinical efficacy,bacteriological efficacy and the occurrence of ADR were compared between 2 groups. The economics of 2 therapy plans were evaluated. RESULTS：Total response rates of group A and B were 90.00% and 93.33%;bacterial clearance rates were85.00% and 86.36%;the incidence of ADR were 3.33% and 6.67%,without statistical significance（P〈0.05）. Minimum cost analysis was adopted for economic evaluation;treatment cost of group A was 16 646.51 yuan,and that of group B was 19 605.74yuan;the cost of group A was lower than group B. The results of minimum cost analysis were supported by sensitivity analysis.CONCLUSIONS：For empiric treatment of antibiotics in elderly CAP patients,moxifloxacin alone should be the first choice. The therapy plan is effective,low-cost and safe.
出处
《中国药房》
CAS
北大核心
2017年第23期3180-3182,共3页
China Pharmacy
基金
江苏省药学会-奥赛康医院药学基金立项课题(No.201504)
