Pharmacoeconomic Evaluation Of Different Antibacterial Regimens In The Treatment Of Lower Respiratory Tract Infection Of Acinetobacter Baumannii

Objective:In this study,the clinical data of patients were collected with lower respiratory tract infection of Acinetobacter baumannii,and the comprehensive effects of different antibacterial regimens were analyzed from the perspectives of clinical efficacy,safety and economy in the treatment of lower respiratory tract infection of Acinetobacter baumannii.The aim was to provide reference for screening antibacterial drugs and selecting antibacterial drugs for physicians in hospitals.Methods:A retrospective investigation of 288 cases of lower respiratory tract infection of Acinetobacter baumannii used cefoperazone/sulbactam or piperacillin/tazobactam in a top three hospital in Xinjiang from January 2015 to December 2017.To collect clinical data,physical signs,laboratory tests,treatment costs and other relevant datas for each patient,and compare the therapeutic effects of the two antibacterial drugs.The decision tree model was used to analyze the cost-effectiveness of the two antibacterial drugs.The multi-attribute utility analysis was used to comprehensively evaluate the effectiveness,safety and economy of the two antibacterial agents.Results:The clinical effective rates of cefoperazone/sulbactam(group A)and piperacillin/tazobactam(group B)were 83.7% and 82.2% in the treatment of lower respiratory tract infections of Acinetobacter baumannii,and the difference was not statistically significant.(P>0.05);the clearance rates of Acinetobacter baumannii were 82.4% and 77.8% in group A and group B,and the difference was not statistically significant(P>0.05);the incidence of adverse reactions were 1.96% and 2.22% in group A and group B in the lower respiratory tract infections of Acinetobacter baumannii,and the difference was not statistically significant(P>0.05).In the decision tree model analysis,the expected cost of the cefoperazone/sulbactam(group A)and the piperacillin/tazobactam(group B)was 487,564 Yuan and 438,737 Yuan in the treatment of lower respiratory tract infections of Acinetobacter baumannii,the cost-effectiveness ratio is 5825 and 5337,compared with cefoperazone/sulbactam and piperacillin/tazobactam,when the effective rate was increased by 1%,the cost of cefoperazone/sulbactam was 32,551 Yuan more than piperacillin/tazobactam.Piperacillin/tazobactam was superior to cefoperazone/sulbactam in economic evaluation.In the multi-attribute utility analysis,the total utility value of the cefoperazone/sulbactam(group A)was 35.14,and the total utility value of the piperacillin/tazobactam(group B)was 35.77.Piperacillin/tazobactam was superior than cefoperazone/sulbactam in the overall evaluation of efficacy,safety,and economy.Conclusions:There was no statistical difference in the clinical efficacy of cefoperazone/sulbactam and piperacillin/tazobactam in the treatment of lower respiratory tract infection of Acinetobacter baumannii;the decision tree model analysis and multi-attribute utility analysis showed that piperacillin/tazobactam was the best antibacterial treatment plan,and the sensitivity analysis was consistent with the above results.