Roy V, Saxena D, Agarwal M, Bahadur A K, Mishra B
Department of Pharmacology, Maulana Azad Medical College, New Delhi, India.
Indian J Cancer. 2010 Oct-Dec;47(4):430-6. doi: 10.4103/0019-509X.73568.
Use of antimicrobials (AM) and granulocyte colony stimulating factors (G-CSF) affect the outcome and cost of treatment of febrile neutropenia (FN). There are no studies describing the AM utilization pattern or the use of G-CSF and cost incurred on them in cancer patients with FN from India.
A study was conducted in a tertiary care, teaching hospital in New Delhi, India, with the objectives of describing the utilization pattern of AM and G-CSF in cancer patients with FN. The efficacy and costs of AM and G-CSF prescribed were also assessed.
A total of 211 patients with FN were enrolled in the study. A majority of 207 (98.1%) were in the low-risk category. The average number of AM used per patient was 2.45 ± 0.02 and the AM exposure density was 1.19. All patients were administered five different combinations of AM regimens and G-CSF, irrespective of the risk category. No difference in the time to defervesence or in the recovery of ANC counts were observed with the different AM regimens. The average drug cost per febrile neutropenia episode (FNE) was Rs 4694.45 ± 296.35 (113.95 ± 7.19$). G-CSF accounted for 76.14 - 97.58% of the total costs.
Large variations in the pattern of AM prescribed with routine use of G-CSF, irrespective of the risk status, was observed. Guidelines for the rational and cost-effective use of AM and G-CSF in patients with FN needed to be prepared. This was especially important as treatment was given free of cost to all patients admitted in the government health facility.
抗菌药物（AM）和粒细胞集落刺激因子（G-CSF）的使用会影响发热性中性粒细胞减少症（FN）的治疗结果和成本。目前尚无研究描述印度癌症患者 FN 中 AM 的使用模式、G-CSF 的使用情况及其产生的成本。
在印度新德里的一家三级护理教学医院进行了一项研究，目的是描述癌症 FN 患者中 AM 和 G-CSF 的使用模式。还评估了所开具的 AM 和 G-CSF 的疗效及成本。
共有 211 例 FN 患者纳入研究。其中大多数 207 例（98.1%）属于低风险类别。每位患者使用 AM 的平均数量为 2.45±0.02，AM 暴露密度为 1.19。所有患者均接受了五种不同的 AM 方案和 G-CSF 组合，无论风险类别如何。不同的 AM 方案在退热时间或中性粒细胞计数恢复方面未观察到差异。每例发热性中性粒细胞减少症发作（FNE）的平均药物成本为 4694.45 卢比±296.35 卢比（113.95±7.19 美元）。G-CSF 占总成本的 76.14 - 97.58%。
观察到无论风险状况如何，常规使用 G-CSF 时 AM 的处方模式存在很大差异。需要制定 FN 患者合理且具有成本效益的 AM 和 G-CSF 使用指南。这一点尤为重要，因为政府医疗机构对所有入院患者免费提供治疗。
