McKinnon P S, Paladino J A, Grayson M L, Gibbons G W, Karchmer A W
Clinical Pharmacokinetics Laboratory, Millard Fillmore Health System, Buffalo, New York, USA.
Clin Infect Dis. 1997 Jan;24(1):57-63. doi: 10.1093/clinids/24.1.57.
A cost-effectiveness analysis was performed following a double-blind, randomized study of ampicillin/sulbactam (A/S) versus imipenem/cilastatin (I/C) for the treatment of limb-threatening foot infections in 90 diabetic patients. There were no significant differences between the treatments in terms of clinical success rate, adverse-event frequency, duration of study antibiotic treatment, or length of hospitalization. Costs of the study antibiotics, treatment of failures and adverse events, and hospitalization were calculated. Mean per-patient treatment cost in the A/S group was $14,084, compared with $17,008 in the I/C group (P = .05), primarily because of lower drug and hospitalization costs and less-severe adverse events in the A/S group. Sensitivity analyses varying drug prices or hospital costs demonstrated that A/S was consistently more cost-effective than I/C. Varying the clinical success rate for each drug revealed that I/C would have to be 30% more effective than A/S to change the economic decisions.
在一项针对90名糖尿病患者的肢体威胁性足部感染的双盲、随机研究中，对氨苄西林/舒巴坦（A/S）与亚胺培南/西司他丁（I/C）进行了成本效益分析。在临床成功率、不良事件发生率、研究抗生素治疗持续时间或住院时间方面，两种治疗方法之间没有显著差异。计算了研究抗生素的成本、失败和不良事件的治疗成本以及住院成本。A/S组的平均每位患者治疗成本为14,084美元，而I/C组为17,008美元（P = 0.05），主要是因为A/S组的药物和住院成本较低，不良事件也较轻。改变药品价格或医院成本的敏感性分析表明，A/S始终比I/C更具成本效益。改变每种药物的临床成功率显示，I/C必须比A/S有效30%才能改变经济决策。
