Comprehensive clinical evaluation of centralized procurement ceftriaxone for injection in the treatment of bacterial infections based on multicenter real-world data
OBJECTIVE To compare the comprehensive clinical value of injectable ceftriaxone from centralized and non-centralized procurement in the treatment of bacterial infection patients through real-world study,and to provide reference for better implementation of centralized procurement policy.METHODS Real-world data of injectable ceftriaxone from centralized and non-centralized procurement were retrospectively collected from 17 centers.The PSM analysis method was used to balance the differences between the groups,and a comprehensive clinical evaluation was carried out from the perspective of effectiveness,safety,economy,and suitability.RESULTS After PSM,510 patients were included in the centralized-procurement group and another 510 patients in the non-centralized-procurement group.Effectiveness evaluation:there were no significant differences in clinical effective rate,72 h effective rate,bacteriological efficacy,and the infection-related indicators(body temperature,WBC,NEUT,NEUT％,CRP,PCT)returned to the normal ranges between the two groups(P＞0.05).Safety evaluation:the inci-dence of AEs and the abnormality rate of AEs-related indicators(WBC,Hb,PLT,EOS,ALT,Urea)were not significantly dif-ferent between the two groups(P＞0.05),and no TBiL abnormality occurred in either group;nonetheless,the abnormal rates of NEUT,AST and Cr in the centralized procurement group were lower than those in the non-centralized procurement group(P＜0.05).Economic evaluation:the cost-minimization analysis showed that the total hospitalization cost,total drug cost during hos-pitalization,and total antibacterial drug cost of the centralized procurement group were lower than those of the non-centralized pro-curement group(P＜0.01);and the results of univariate sensitivity analysis were consistent with those of cost-minimization analy-sis.Suitability evaluation:the suitability score of ceftriaxone from centralized procurement was higher than that from non-centralized procurement(95.5 vs.93).CONCLUSION The effectiveness of centralized procurement of ceftriaxone for injection is not inferior to non-centralized procurement,and the safety is equivalent as well.However,centralized procurement has more economic advantages than non-centralized procurement,and the suitability of centralized procurement reflects certain advantages to varying degrees compared to that of non-centralized procurement.
centralized procurementceftriaxone for injectionmulticenterreal-world datapropensity score matchingcom-prehensive clinical evaluation
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