关键词: 肺部感染, 鲍氏不动杆菌, 抗菌药物, 头孢哌酮/舒巴坦, 哌拉西林/他唑巴坦, 决策树

Abstract: Background　With the rapid development of medical standards，under the premise of ensuring the safety and effectiveness of medication，reducing medical costs as much as possible has become an urgent problem for medical institutions.Therefore，using the principles of pharmacoeconomics to evaluate the costs and corresponding effects of drug treatment as well as the relationship between them has important guiding significance for the selection and formulation of optimal drug regimens.Objective　To carry out the pharmacoeconomic evaluation of cefoperazone/sulbactam and piperacillin/tazobactam in the treatment of pulmonary infection with Acinetobacter Baumannii in order to provide a reference for clinical rational drug use.Methods　A retrospective investigation of 288 patients of pulmonary infection with Acinetobacter Baumannii in the First Affiliated Hospital，School of Medicine，Shihezi University was carried out from 2015 to 2017.According to the antibacterial treatment regime，the cefoperazone/sulbactam group（group A） had 153 patients and the piperacillin/tazobactam group （group B） had 135 patients.The therapeutic effects of the two groups were compared and a decision tree model was constructed for cost-effectiveness analysis.Results　There were no significant differences in white blood cell count （WBC），C-reactive protein （CRP） and procalcitonin （PCT） between the two groups before and after treatment （P>0.05）．The levels of WBC，CRP and PCT in the two groups after treatment were lower than those before treatment （P<0.05）．There were no significant differences in the time for body temperature returned to normal，improvement time for cough and expectoration，and improvement time for chest tightness and shortness of breath between the two groups （P>0.05）．There was no significant difference in the incidence of adverse reactions between the two groups 〔2.0%（3/153）vs 2.2%（3/135），χ2=0.07，P=0.80〕.There was no significant difference in the effective rates of drugs between the two groups 〔group A=83.7%（128/153），group B=82.2%（111/135），χ2=0.11，P=0.75〕.The expected costs of the two groups were 487 564 yuan and 438 737 yuan，and the cost-effectiveness ratio was 5 825 and 5 337.The cost of cefoperazone/sulbactam for each unit of clinical effect was 32 551 yuan more than piperacillin/tazobactam.Conclusion　There is no difference in the efficacy and incidence of adverse reactions of cefoperazone/sulbactam and piperacillin/tazobactam in the treatment of pulmonary infection with Acinetobacter Baumannii，but piperacillin/tazobactam has economic advantages.

Key words: Pulmonary infections, Acinetobacter Baumannii, Anti-bacterial agents, Cefoperazone/sulbactam, Piperacillin/tazobactam, Decision trees