本文選題：A族β溶血性鏈球菌 + 急性上呼吸道感染��； 參考：《中國藥房》2017年17期

【摘要】：目的:對治療A族β溶血性鏈球菌(GAS)致急性上呼吸道感染的3種方案的經(jīng)濟性進行評價。方法:采用回顧性研究方法,選擇我院2014年3月-2016年3月臨床表現(xiàn)為急性上呼吸道感染且用咽拭子試驗分離出GAS呈陽性的患者71例,按用藥方法不同分為A組(16例)、B組(30例)和C組(25例)。A、B、C組患者分別采用一次性肌內(nèi)注射芐星青霉素(120萬U)、口服青霉素V鉀(約0.5 g,q8 h,療程10 d)、口服阿莫西林舒巴坦匹酯(1.0 g,bid,療程10 d)3種治療方案,觀察臨床療效及細菌清除情況,并對3種方案進行經(jīng)濟學評價。結(jié)果:3組患者的治愈率分別為87.50%、90.00%、92.00%,細菌清除率分別為88.24%、87.88%、92.59%,差異均無統(tǒng)計學意義(P0.05),故采用最小成本分析法進行藥物經(jīng)濟學評價。3種方案的成本分別為237.79、279.49、400.40元,其中C方案的治愈率和細菌清除率最高,但成本也最高。敏感度分析結(jié)果與最小成本分析結(jié)果一致。結(jié)論:對于明確病原性細菌為GAS所致的反復發(fā)作的上呼吸道感染且有誘發(fā)風濕熱風險的患者,肌內(nèi)注射芐星青霉素可作為首選治療方案;對于不愿接受注射用青霉素治療且能保證用藥時間的患者,可選擇口服青霉素V鉀;對于普通青霉素治療效果不佳的患者,可選擇口服阿莫西林舒巴坦匹酯。
[Abstract]:Objective: to evaluate the economy of three methods for the treatment of acute upper respiratory tract infection caused by group A 尾 hemolytic streptococcus. Methods: a retrospective study was carried out in 71 patients with acute upper respiratory tract infection (ARI) from March 2014 to March 2016 and GAS positive by pharynx swab test. Patients in group A (n = 16) and group C (n = 25) were treated with a single intramuscular injection of benzylpenicillin (1.2 million U) and penicillin V potassium (0.5 g / g Q8 h) for 10 days. Tampiramate 1.0 g bid, treatment course 10 days, 3 kinds of treatment plan, The clinical efficacy and bacterial clearance were observed, and the economic evaluation of three schemes was carried out. Results the cure rates of the three groups were 87.50 and 90.000.The bacterial clearance rates were 88.24 and 87.889.599.The difference was not statistically significant, so the cost of using the least cost analysis method to evaluate the pharmacoeconomics of the three schemes was 237.79279.49.400.40 yuan, respectively. Among them, the cure rate and bacterial clearance rate of C regimen were the highest, but the cost was also the highest. The result of sensitivity analysis is consistent with that of minimum cost analysis. Conclusion: for patients with recurrent upper respiratory tract infection caused by GAS and risk of rheumatic fever, intramuscular injection of benzylpenicillin can be the first choice. Patients who do not want to be treated with penicillin for injection and who can guarantee the duration of drug use can choose penicillin V potassium orally, and patients with poor efficacy of penicillin can choose amoxicillin sulbactam.
【作者單位】： 西南大學醫(yī)院藥劑科;西南大學醫(yī)院眼耳鼻喉科;重慶市第六人民醫(yī)院藥劑科;
【基金】：西南大學基本科研業(yè)務費專項資金項目(No.XDJK2014C084)
【分類號】：R56

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