Ota Shuichi, Wada Akinori, Kosugi Mizuha, Matsuoka Satomi, Asanuma Shinsuke, Fujii Shiro, Noguchi Shinsuke, Nakata Masanobu, Imai Kiyotoshi, Hirano Teiichi, Kobayashi Naoki, Ogasawara Masahiro, Kiyama Yosio, Kasai Masaharu
Department of Hematology, Sapporo Hokuyu Hospital.
Rinsho Ketsueki. 2010 Jan;51(1):63-8.
Systemic fungal infection (SFI) is now one of the main causes of death from infective complications after hematopoietic stem cell transplantation (HSCT) and the role of prophylaxis of fungal infection has been established. However, there is no evidence evaluating the cost-benefit ratio of SFI management in Japan. To estimate the medical costs on prophylaxis and treatment of SFI in HSCT, we embarked on a randomized control prospective study of the medical cost-benefit ratio comparing fluconazole with itraconazole for antifungal prophylaxis in 40 patients who received HSCT in our hospital. Despite the similarity of efficacy for prophylaxis, the median cost of itraconazole prophylaxis between Day-10 and Day+28 was significantly less than that of fluconazole. There are many patients who require an i.v. formulation because of non-compliance with oral administration after HSCT and these cases cause increased medical costs. Therefore, further investigation is needed not only regarding differences among prophylactic agents but also regarding differences in administration routes focusing on the cost-effectiveness of treatment.
系统性真菌感染（SFI）现已成为造血干细胞移植（HSCT）后感染性并发症致死的主要原因之一，真菌感染预防的作用已得到确立。然而，在日本尚无评估SFI管理成本效益比的证据。为估算HSCT中SFI预防和治疗的医疗成本，我们开展了一项随机对照前瞻性研究，比较在我院接受HSCT的40例患者中，使用氟康唑和伊曲康唑进行抗真菌预防的医疗成本效益比。尽管预防效果相似，但在第10天至第28天期间，伊曲康唑预防的中位成本显著低于氟康唑。HSCT后有许多患者因不依从口服给药而需要静脉制剂，这些情况导致医疗成本增加。因此，不仅需要进一步研究预防药物之间的差异，还需要关注给药途径差异对治疗成本效益的影响。
