2022 年第 1 期 第 17 卷

哌拉西林他唑巴坦与头孢唑肟治疗医院获得性肺炎的有效性和药物经济学研究

Efficacy and pharmacoeconomics of piperacillin tazobactam and ceftizoxime on the treatment of hospital-acquired pneumonia

作者：周艳红1吴梅2张宁3

英文作者：Zhou Yanhong1 Wu Mei2 Zhang Ning3

单位：1重庆大学附属肿瘤医院医保科，重庆400030；2重庆大学附属肿瘤医院教务科，重庆400030；3重庆大学附属肿瘤医院重症医学科，重庆400030

英文单位：1Department of Medical Insurance Chongqing University Cancer Hospital Chongqing 400030 China; 2Department of Educational Administration Chongqing University Cancer Hospital Chongqing 400030 China; 3Department of Critical Medicine Chongqing University Cancer Hospital Chongqing 400030 China

关键词：医院获得性肺炎；哌拉西林他唑巴坦；头孢唑肟

英文关键词：Hospital-acquiredpneumonia;Piperacillintazobactam;Ceftizoxime

• 摘要：

• 目的 比较哌拉西林他唑巴坦与头孢唑肟治疗医院获得性肺炎（HAP）的有效性和药物经济学指标。方法 选取2020年1—12月重庆大学附属肿瘤医院重症医学科收治的94例HAP患者，采用随机数字表法分为A组和B组，各47例。A组予注射用头孢唑肟静脉滴注治疗，B组予注射用哌拉西林钠他唑巴坦钠静脉滴注治疗，2组均治疗7 d。比较2组临床疗效、细菌清除率、临床症状恢复时间、实验室指标及药物经济学指标。结果 2组总有效率、细菌清除率及患者咳痰、咳嗽、气促及体温恢复时间比较差异均无统计学意义（均P＞0.05）。2组治疗期间均未见不良反应发生。治疗后2组C反应蛋白及降钙素原水平均显著低于治疗前［A组：（10±3）mg/L比（53±6）mg/L、（0.11±0.02）μg/L比（1.12±0.26）μg/L；B组：（10±3）mg/L比（53±7）mg/L、（0.10±0.04）μg/L比（1.06±0.31）μg/L］（均P＜0.05），但组间比较差异均无统计学意义（均P＞0.05）。B组直接成本低于A组［（4 645±120）元比（5 011±122）元］，多因素敏感性分析后B组直接成本仍低于A组［（4 607±115）元比（4 781±100）元］，差异均有统计学意义（均P＜0.001）。结论  哌拉西林他唑巴坦与头孢唑肟治疗HAP的效果相当，但前者经济学优势更明显。

• Objective   To compare the efficacy and pharmacoeconomic indicators between piperacillin tazobactam and ceftizoxime on the treatment of hospital-acquired pneumonia(HAP). Methods  From January to December 2020, 94 patients with HAP in Department of Critical Medicine, Chongqing University Cancer Hospital were selected. Patients were randomly divided into group A and group B, with 47 cases in each group. Group A was treated with ceftizoxime sodium for injection intravenous dripping, and group B was treated with piperacillin sodium and tazobactam sodium for injection intravenous dripping. Both groups were treated for 7 d. The clinical efficacy, bacterial clearance rate, recovery time of clinical symptoms, laboratory indexes and pharmacoeconomic indicators were compared between the two groups. Results  There were no significant differences in the total effective rate, bacterial clearance rate, and recovery time of expectoration, cough, shortness of breath and body temperature between the two groups(all P>0.05). There was no adverse reaction during treatment. After treatment, C-reactive protein and procalcitonin levels in the two groups were significantly lower than those before treatment［group A:（10±3）mg/L vs （53±6）mg/L, （0.11±0.02）μg/L vs （1.12±0.26）μg/L; group B:（10±3）mg/L vs （53±7）mg/L, （0.10±0.04）μg/L vs （1.06±0.31）μg/L］ (all P<0.05), but there were no significant differences in those between the two groups(both P>0.05). The direct cost in group B was lower than that in group A ［（4 645±120）yuan vs （5 011±122）yuan ］, and that in group B after multivariate sensitivity analysis was also lower than that in group A［（4 607±115）yuan vs （4 781±100）yuan］(both P<0.001). Conclusion  There is no difference in clinical efficacy between piperacillin tazobactam and ceftizoxime on the treatment of HAP, but the former has more obvious advantage of pharmacoeconomics.