不同配比哌拉西林他唑巴坦治疗复杂性尿路感染的疗效、安全性和药物经济性评价
Evaluation of efficacy,safety and economy of different proportions of piperacillin tazobactam for compli-cated urinary tract infection
胡鳞方 1谭松松 2张家兴 1陈琦 1钱鑫 1张瑞 1王海欧 3杨义 4黄雪梅 5王宇奇 6姚磊 7王靖雯 8于佳 9杨亮10
作者信息
- 1. 贵州省人民医院药剂科,贵州贵阳 550002
- 2. 贵州省人民医院医疗保险管理处,贵州贵阳 550002
- 3. 黔西南布依族苗族自治州人民医院药学部,贵州兴义 562400
- 4. 贵州医科大学附属医院药剂科,贵州贵阳 550004
- 5. 铜仁市人民医院药学部,贵州铜仁 554300
- 6. 浙江省人民医院毕节医院药学部,贵州毕节 551700
- 7. 贵州医科大学第二附属医院药剂科,贵州凯里 556000
- 8. 贵阳市第一人民医院药剂科,贵州贵阳 550000
- 9. 贵州中医药大学第一附属医院药学部,贵州贵阳 550001
- 10. 贵州中医药大学第二附属医院药学部,贵州贵阳 550001
- 折叠
摘要
目的:探讨不同配比的国产哌拉西林他唑巴坦治疗复杂性尿路感染的疗效、安全性和经济性,为临床合理用药和卫生决策提供参考.方法:该研究为多中心回顾性队列研究,数据来源于贵州省9家三级综合性医院,纳入2020年1月至2022年12月诊断为复杂性尿路感染的患者,以使用不同配比的哌拉西林他唑巴坦作为暴露因素,采用倾向性评分匹配(propensity score matching,PSM)法控制2组患者的年龄、民族、并发症、疗程等混杂因素,评价2组哌拉西林复方制剂的疗效、安全性和经济性.结果:共纳入881例复杂性尿路感染的患者,观察组使用哌拉西林他唑巴坦(8∶1)的有796例,对照组使用哌拉西林他唑巴坦(4∶1)的有85例.采用PSM后,共成功匹配231例,其中观察组161例,对照组70例,所有变量均匹配均衡(P＞0.05).哌拉西林他唑巴坦(8∶1)的临床疗效优于哌拉西林他唑巴坦(4∶1),且差异有统计学意义(P=0.009);2组间不良反应差异无统计学意义(P=0.605);哌拉西林他唑巴坦(8∶1)的抗感染治疗总费用少于哌拉西林他唑巴坦(4∶1),差异有统计学意义(P＜0.01).结论:哌拉西林他唑巴坦(8∶1)和哌拉西林他唑巴坦(4∶1)治疗复杂性尿路感染安全性良好,但哌拉西林他唑巴坦(8∶1)疗效更佳,且具有更优的经济性.
Abstract
OBJECTIVE To explore the efficacy,safety and economy of different ratios of domestic piperacillin tazobactam(PT)for complicated urinary tract infection(cUTI)to provide references for clinical rational drug use and proper health decision-making.METHODS This was a multi-center retrospective cohort study at 9 tertiary general hospitals in Guizhou Province.Between January 2020 and December 2022,cUTI patients received different ratios of PT as exposure factors.Confounding fac-tors such as age,nationality,co-morbidity and therapeutic duration were controlled by propensity score matching(PSM).Effi-cacy,safety and economy of two groups of PT were evaluated.RESULTS Among 881 eligible cUTI patients,two groups of PT(8∶1,n=796)and PT(4∶1,n=85)were assigned.After PSM,231 cases were successfully matched and divided into two groups of observation(n=161)and control(n=70).And all variables were matched evenly(P＞0.05).Clinical efficacy of PT(8∶1)was better than that of PT(4∶1)with statistically significant difference(P=0.009).No significant inter-group difference existed in adverse reactions(P=0.605).Total therapeutic expense of PT(8∶1)was lower than that of PT(4∶1).There was sta-tistically significant difference(P＜0.001).CONCLUSION PT(8∶1)and PT(4∶1)have comparable safety for cUTI.How-ever,piperacillin tazobactam(8∶1)is more efficacious and economical.
关键词
复杂性尿路感染/哌拉西拉他唑巴坦/倾向性评分匹配/疗效Key words
complicated urinary tract infection/piperacillin tazobactam/propensity score matching/efficacy引用本文复制引用
基金项目
国家自然科学基金(72064004)
贵州省卫生健康委科学技术基金(gzwkj2023-262)
贵州省卫生健康委科学技术基金(gzwkj2021-553)
出版年
2024
NETL
NSTL
万方数据