Evaluation on efficacy,safety and economic of meropenem and cefoperazone/sulbactam in treatment of ESBLS-producing Enterobacteriaceae bloodstream infection
Objective To compare the cost and efficacy of meropenem and cefoperazone/sulbactam in the treatment of ESBLs producing Enterobacteriaceae bacterial bloodstream infections,and provide reference for rational drug use.Methods A retrospective statistical analysis was conducted on the medical records of patients with ESBLs and Enterobacteriaceae bloodstream infections in BinHu District of Hefei First People's Hospital from January 2020 to May 2022.Based on comprehensive consideration of treatment efficacy and adverse drug reactions,cost-minimization analysis method was used for pharmacoeconomic evaluation.Results A total of 67 cases and 68 cases of ESBLs producing Enterobacteriaceae bacterial bloodstream infections were collected in the treatment with meropenem(group A)and cefoperazone/sulbactam(group B),respectively.There was no significant difference in the general situation between the two groups.After treatment with antibiotics,there was no significant difference in the effective rate(95.52％vs 98.53％,P=0.303)and bacterial clearance rate(95.52％vs 97.06％,P=0.636)between the two groups.After discontinuation of the two antibacterial drugs,the CRP indicators were 5.97 and 6.82 mg·L-1,respectively(P=0.391),and the PCT indicators were 0.29 and 0.21 ng·mL-1,respectively(P=0.228),with no statistically significant difference in the inflammatory indicators.There was no significant difference in the recovery time of body temperature and white blood cell,duration of antimicrobial treatment and length of hospital stay between the two groups.Neither treatment group had serious adverse reactions.Therefore,a cost-effectiveness analysis was conducted using the cost-minimization analysis method for both groups.The results showed that the direct medical cost of the meropenem group was slightly higher than that of the cefoperazone/sulbactam group(25 725.95 yuan vs 25 277.62 yuan,P=0.914),while the drug costs,the examination and treatment costs and the nursing and bed expenses of the Meropenem group were all higher than those of the cefoperazone/sulbactam group,and the difference was not statistically significant.Conclusion The clinical efficacy and safety of meropenem and cefoperazone/sulbactam in the treatment of producing ESBLs bloodstream infection were comparable,while cefoperazone/sulbactam had slight economic advantages.
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