Cost-effectivess Analysis Of Three Therapeutic Schemes For Type2Diabetes Mellitus And Optimized The Therapeutic Regimen Of Time-dependet Antimicrobial Agents With Severe Infection And Hypoalbuminemia

These works include two parts.Firstly, using the cost-effectiveness to compare and analyze of threetherapeutic schemes for type2diabetes mellitus. Using the basic idea ofpharmacoeconomics to evaluate cost-effect analysis method for threetherapeutic schemes (oral glucose-lowering drugs, oral glucose-loweringdrugs+insulin injection one time, insulin injection twice).The threetherapeutic schemes average costs were827.3yuan/3months,1714.5yuan/3months and1087.5yuan/3months, respectively; the efficiency ofcontrol fasting blood glucose were56.51%,51.69%and57.04%,respectively; the efficiency of control2h postprandial blood sugar were50.56%,40.68%and55.63%, respectively; the cost-effectiveness ratio offasting blood glucose were14.64,33.16and19.06, respectively; thecost-effectiveness ratio of2h postprandial blood sugar were16.36,42.15and19.55, respectively. Compared with the oral glucose-lowering drugsgroup, the cost-effective ratios cost of control fasting blood glucose and control2h postprandial blood glucose were-184.4and-89.8for oralglucose-lowering drugs+insulin injection one time group, respectively; thecost-effective ratios cost of control fasting blood glucose and control2hpostprandial blood glucose were484.8and51.26for oral glucose-loweringdrugs+insulin injection twice group, respectively. According to theprinciples of economics, oral medication has the highest cost-effectivenessratio in the treatment for type2diabetes mellitus, and oral medication+insulin injection twice has better therapeutic efficacy.Secondly, hypoalbuminemia is a common complication in thepatients with severe infection. The effects of hypoalbuminaemia onpharmacokinetics and pharmacodynamics are associated with the decreaseof protein-bound antibacterials and increase of the unbound fraction ofantibacterials. Hence, it is important to optimize the therapeutic regimen ofantimicrobial agents, to improve curative effect, and to reduce adversereactions, for the patients with hypoalbuminemia. The aim of this work isto discuss the relationship between severe infection and hypoalbuminemia,and to provide valuable insights for the clinical rational use oftime-dependent antibacterial agents.