Economics Analysis Of Three Kinds Of Antibiotics In The Treatment Of Elderly Patients With HAP

Objective:Analyze the economy of three kinds of antibiotics in treatment of senile patients with hospital acquired pneumonia, so as to provide guidance for clinical rational drug use.Methods:A retrospective survey was conducted in the patients suffered from hospital acquired pneumonia from January 2013 to June 2014 in Fujian Provincial Geriatric Hospital.150 cases were picked out in line with the treatment of study and divided into three groups(group A: cefoperazone sodium and sulbactam sodium; group B: piperacillin sodium and tazobactm sodium; group C: meropenem). With analysis of distribution of pathogens, drug resistance, bacterial clearance rate and adverse drug reaction, economic analysis of three therapeutic schemes by data method, decision tree model and multi-attribute utility theory, the most cost-effective treatment scheme was seleced.Results:1. Results from bacteriologyThe main pathogenic bacteria of sensitivity was good and bacterial clearance rate was the highest in group B.2. Results from the data analysis methodGroup A: ￥6558.43 of cost, 69.81% of efficiency, the cost effectiveness ratio of 93.95; Group B: ￥6092.08 of cost, 69.81% of efficiency, the cost effectiveness ratio of 87.27; Group C: ￥12052.36 of cost, 81.82% of efficiency, the cost effectiveness ratio of 147.30. The effectiveness of three groups had no statistical difference. Group B had the lowest cost, and was the best. Compared with group B, an increase of one effectiveness unit using Group C requires an additional cost of ￥496.28.3. Results from the decision tree analysisGroup A: ￥7054.73 of the expected cost, the expected cost effectiveness ratio of 78.39; Group B: ￥6248.95 of the expected cost, the expected cost effectiveness ratio of 76.49; Group C: ￥12179.94 of the expected cost, the expected cost effectiveness ratio of141.76.4. Results from the multi-attribute utility analysisThe total scores of group A, B, and C were 50.49, 62.37 and 47.80 respectively. Group B was the best.5. Sensitivity analysisThe conclusions were not affected by using single and multiple factor sensitivity analysis.6. Adverse reactionGroup A had one case of dysbacteriosis and one case of subcutaneous congestion; Group B and C had no adverse reaction case. The incidence of adverse reactions among th- e three groups had no statistical difference.Conclusions:For the first time, cefoperazone sodium and sulbactam sodium, piperacillin sodium and tazobactam sodium, meropenem of sino foreign joint venture manufacturers were a- nalysed by three different methods in the treatment of senile patients with hospital acquired pneumonia. There were no statistical significant in bacteriological efficacy, clinical curative effect and adverse reaction in three kinds of antibiotics; The Cost effectiveness ratio of piperacillin sodium and tazobactam sodium was the lowest, compared with cefoperazone sodium and sulbactam sodium, meropenem, ￥6.68 and ￥ 60.03 of the cost can be saved respectively if one valid result was got; It showed that piperacillin sodium and tazobactam sodium was the most economical scheme by analysis of data method, decision tree analysis and multi-attribute utility analysis; It also showed that the results of economics analysis were stable by sensitivity analysis. Therefore, piperacillin sodium and tazobactam was the best scheme for clinica treatment of senile patients with hospital acquired pneumonia by these three conventional means in this study.