目的 探討亞胺培南不同給藥方案治療院內(nèi)常見耐藥菌血流感染的經(jīng)濟(jì)學(xué)效果。方法 調(diào)查中山市人民醫(yī)院2019—2020年應(yīng)用亞胺培南治療院內(nèi)常見耐藥菌血流感染病例共151例，按照實(shí)際給藥分為A方案：0.5 g/次，每12小時(shí)給藥1次（q12h）；B方案：0.5 g/次，每8小時(shí)給藥1次（q8h）；C方案：1 g/次，q12h；D方案：1 g/次，q8h；E方案：1 g/次，每6小時(shí)給藥1次（q6h）。分別進(jìn)行蒙特卡洛模擬（MCS），計(jì)算各方案的累積反應(yīng)分?jǐn)?shù)（CFR），進(jìn)行成本效果分析（CEA）。結(jié)果 5組方案的成本效果比（C/E）分別為68.5、68.2、100.4、82.6、93.1，以A方案為參照，余下4種方案的增量成本效果比（△C/△E）分別為65.9、845.1、147.2、201.8。結(jié)論 C/E最小的B方案對(duì)多重耐藥鮑曼不動(dòng)桿菌（MDR-AB）、耐碳青霉烯類銅綠假單胞菌（CRPA）和耐碳青霉烯類腸桿菌科（CRE）的抗菌活性較差，并非院內(nèi)常見耐藥菌血流感染最理想的方案，應(yīng)結(jié)合臨床耐藥菌種選擇給藥方案。D方案的藥物經(jīng)濟(jì)學(xué)評(píng)價(jià)效果優(yōu)于C方案和E方案，且更多給藥頻次的E方案并未體現(xiàn)出更高收益。

Objective To evaluate the economic effects of different dosage regimens of imipenem against hospital common drug-resistant bacteria blood infection. Methods A total of 151 cases using imipenem against hospital common drug-resistant bacteria blood infection were investigated in Zhongshan City People's Hospital from 2019 to 2020 were divided into 5 groups according to actual dosage regimens. group A (0.5 g, q12h), group B (0.5 g, q8h), group C (1 g, q12h), group D (1 g, q8h) and group E (1 g, q6h). These dosage regimens were evaluated with Monte Carlo simulation (MCS), caluated for cumulative fraction responses (CFR), and conducted cost-effectiveness analysis (CEA) respectively. Results the C/E values of the 5 groups were 68.5, 68.2, 100.4, 82.6 and 93.1 respectively. Taking A regimen as the reference, the incremental cost effectiveness ratio(∆C/∆E) of other 4 regimens were 65.9, 845.1, 147.2, and 201.8 respectively. Conclusion Regimen B with the least C/E value had poor antibacterial activity against multi-drug resistant Acinetobacter baumannii (MDR-AB), carbapenem resistant Pseudomonas aeruginosa (CRPA) and carbapenem resistant enterobacteriaceae (CRE), which is not the best regimen for the hospital common drug-resistant bacteria blood infection. Dosage regimen should be selected combinating with clinical drug resistant strains. Regimen D is more effective than regimen C and regimen E, and regimen E with more administration frequency does not show higher benefit.

R978.1

中山市科技局項(xiàng)目（2019B1076）