Paladino J A
Clinical Pharmacokinetics Laboratory, Millard Fillmore Hospitals, State University of New York at Buffalo.
Pharmacoeconomics. 1994 Jun;5(6):505-12. doi: 10.2165/00019053-199405060-00006.
A retrospective cost-effectiveness analysis, from the institutional perspective, was performed on the 1637 clinically evaluable patients who participated in randomised studies of cefepime versus ceftazidime. The clinical success rate was 88% for patients in both the cefepime and ceftazidime groups. Adverse events occurred in 16.5% of cefepime and 19.0% of ceftazidime patients (p greater than 0.05). In most cases cefepime was administered every 12 hours while ceftazidime was administered every 8 hours. The amount of drug administered per patient (mean+/-SEM) was 17.6+/-0.4g of cefepime and 29.1+/-0.8g of ceftazidime (p less than 0.01). The median number of days of antibiotic treatment was 8 for each group. Decision and sensitivity analyses of drug price and hospital bed cost demonstrated that cefepime was consistently more cost effective than ceftazidime. The probability of clinical success varied between 60 and 97% and revealed that ceftazidime would have to be 31% more effective than cefepime to change the economic decision. If the acquisition prices per gram of drug are similar, cefepime will be cost effective compared with ceftazidime.
从机构角度对1637例参与头孢吡肟与头孢他啶随机研究的可临床评估患者进行了回顾性成本效益分析。头孢吡肟组和头孢他啶组患者的临床成功率均为88%。头孢吡肟组16.5%的患者和头孢他啶组19.0%的患者发生了不良事件（p>0.05）。在大多数情况下，头孢吡肟每12小时给药一次，而头孢他啶每8小时给药一次。每位患者的给药量（均值±标准误）为头孢吡肟17.6±0.4g，头孢他啶29.1±0.8g（p<0.01）。每组抗生素治疗的中位天数均为8天。药物价格和医院床位成本的决策及敏感性分析表明，头孢吡肟始终比头孢他啶更具成本效益。临床成功的概率在60%至97%之间变化，结果显示头孢他啶的疗效必须比头孢吡肟高31%才能改变经济决策。如果每克药物的采购价格相似，与头孢他啶相比，头孢吡肟将具有成本效益。
