A Hospital Community-acquired Pneumonia Drug Research And Economic Analysis

Objective:The scheme was studied by gathering the cases according to the research project,which aimed to understand the adult community-acquired pneumonia drug treatment and evaluate the rationality, drug therapy of drug treatment.Methods:The research regarded the adults diagnosed with community-acquired pneumonia as the research object, using clinical cases about the scene investigation method. The adults mentioned before from march 2014 to march 2015 were registrated and the information were extracted.The patients’ basic information such as gender, age, occupation, weight,history of drug allergy, history of bad habits(smoking or drinking),history of drug allergy and the patients’ medication information including antibacterial drugs use the name, specification, manufacturer, usage, dosage, course of treatment, treatment records were collected according to the design in advance. Establish a database, The data statistics and analysis were processed by establishing a database.Results:The first part Drug use92 cases were selected according to the inclusion criteria and exclusion criteria. The total number of antimicrobial agents used with patients was 221 and the average number of antimicrobial drug use was 2.4 ±1.1; the species of antimicrobials items were 15 and beta lactam antibiotics was in the majority. There was 4 cases suffering from adversereactions and the incidence of adverse reactions was 4.35%. The drugs with adverse reactions were azithromycin, cefoperazone sodium he azole, levofloxacin.The cases were divided into 4 species according to whether the drugs can be combinated.The first category: alone(such as cefoperazone sodium he azole sodium),the total number was11 cases; the second category: duplex drugs(such as quinolone class,cephalosporin joint), the total number was 51 cases; the third class: triple drug cefepime(such as levofloxacin injection + sodium he thiazole ba jotham sodium + other drugs),the total number was19 cases;the forth class: more than quadruple use of antimicrobial agents, the total number was 11 cases.Five groups dosing regimen are got through information extraction performed on four types of case: group A: cefoperazone sodium he azole sodium, a total of 5 cases;group B: levofloxacin injection + cephalosporins pp sodium he azole sodium, a total of18 cases; group C: levofloxacin injection + cephalosporins pp sodium he thiazole ba na +other, a total of 9 cases; group D: levofloxacin injection + or cefoxitin sodium cefuroxime sodium, a total of 14 cases; group E: levofloxacin or moxifloxacin sodium injection + pp ketone cephalosporin cefepime he thiazole ba jotham sodium or pp ketone shu ba sodium, a total of 24 cases.The second part Economic analysisThe total hospital cost of collected 92 cases was 1444122.3 yuan, and the average of hospitalization cost was 15869.5±8942.6 yuan; the total hospitalization expenses for medicine was 695497.8 yuan, and the average of total hospitalization expenses for medicine was 7642.8±5739.6 yuan. The total treatment(antibacterial) expenses for medicine were 331010.7 yuan, and the average was 3637.5±2937.2 yuan. The average of total hospitalization expenses for medicine accounted for 48.2% of the total cost, and the average(antibacterial) drug treatment accounted for 47.6% of the total hospitalization expenses for medicine.The total effective rate of the five groups dosing regimen in group A, group B,group C, group D, group E was separately 100%, 94.4%, 100%, 92.9%, 95.8%. Therewas no difference among the five groups for effective rate(P > 0.05). Incidence of adverse reactions in group A, group B, group C, group D, group E was 0, 5.6%, 0, 0,4.2%. The was significant difference among the five groups for the incigence of adverse reactions(P < 0.05). The average cost of group A, group B, group C, group D, group E was 2579.7±1223.1 yuan, 3523.5±1513.7 yuan, 5622.2±1673.7 yuan, 2066.1±725.2 yuan,3922.1±2012.2 yuan. The difference was statistically significant(P < 0.05). According to the minimum cost analysis, group D was the preferably program. Cost-effectiveness ratio of group A, group B, group C, group D, group E was 2579.7, 3732.0, 5622.2, 2224.0,4094.1. And the smaller the ratio, the more efficient and more economic valued.Through the analysis of the drug treatment of this disease, group D is the high efficient, less side effects and low cost treatment. Our work provided clinical medicine basis for the treatment of community-acquired pneumonia.Conclusions:1. The mainly use of antimicrobial agents in community-acquired pneumonia in the hospital is the beta lactam antibiotics and quinolones.2. Through the economics analysis of community-acquired pneumonia regimen, the cost and effect ratio in levofloxacin injection group, cefoxitin sodium cefuroxime sodium group or in combination group was the least. The regimen is of great economic value.