Pham Dang C, Gouin F, Touchais S, Richard C, Potel G
Clinique chirurgicale orthopédique, Hôtel-Dieu, CHR 44093 Nantes, France.
Pathol Biol (Paris). 2001 Sep;49(7):587-96. doi: 10.1016/s0369-8114(01)00203-6.
This clinical and economical study compared two glycopeptides regimen i.e., vancomycin and teicoplanin in the treatment of osteoarticular infection involving methicillin-resistant staphylococcus. After randomization, 15 patients (group 1) received vancomycin (23 F per gram) in continuous infusion through a central venous catheter and 15 others (group 2) intramuscular teicoplanin (311-357 F a 400 mg vial). The clinical study focused on treatment tolerance in an in-patient setting as well as in a non in-patient one. The cost analysis focused on total expenses including those of antibiotics, those of medical devices for antibiotic administration and those of the complications caused by the antibiotics use. Total expenses per patient averaged 8744 F with vancomycin and 8555 F with teicoplanin (NS). The apparent money saving by using a cheap antibiotic (i.e. vancomycin) was illusionary as one took in account the expenses for medical devices e.g., central venous catheters required to administer vancomycin and the complications due to the use of these devices.
这项临床与经济学研究比较了两种糖肽类药物治疗方案,即万古霉素和替考拉宁,用于治疗耐甲氧西林金黄色葡萄球菌引起的骨关节炎感染。随机分组后,15例患者(第1组)通过中心静脉导管持续输注万古霉素(每克23法郎),另外15例患者(第2组)肌肉注射替考拉宁(每400毫克小瓶311 - 357法郎)。临床研究聚焦于住院及非住院环境下的治疗耐受性。成本分析聚焦于总费用,包括抗生素费用、抗生素给药的医疗设备费用以及抗生素使用引起的并发症费用。使用万古霉素时每位患者的平均总费用为8744法郎,使用替考拉宁时为8555法郎(无显著差异)。使用便宜抗生素(即万古霉素)表面上节省的费用是虚幻的,因为考虑到了医疗设备的费用,例如,输注万古霉素所需的中心静脉导管以及使用这些设备引起的并发症。