目的 比较注射用美罗培南和注射用头孢哌酮钠舒巴坦钠治疗产超广谱β-内酰胺酶（ESBLs）肠杆菌科细菌血流感染患者的成本和疗效，为合理用药提供参考。方法 回顾性统计分析合肥市第一人民医院滨湖院区2020年1月—2022年5月产ESBLs肠杆菌科细菌血流感染患者病历，在综合考虑治疗效果和药品不良反应基础上，运用最小成本分析法进行药物经济学评价。结果 分别纳入美罗培南组（A组）和头孢哌酮钠舒巴坦钠组（B组）患者67例和68例，两组一般情况无显著性差异。经抗菌药物治疗后，两组总有效率（95.52% vs 98.53%，P＝0.303）、细菌清除率（95.52% vs 97.06%，P＝0.636）均无显著性差异；两组抗菌药物停用后炎症指标C反应蛋白（CRP）分别为5.97、6.82 mg·L^-1（P＝0.391）、降钙素原（PCT）分别为0.29、0.21 ng·mL^-1（P＝0.228），差异无统计学意义；两组体温及白细胞恢复正常时间、抗菌药物疗程和住院时间也未见显著性差异，两治疗组均未见严重不良反应。采用最小成本分析法对两组行成本效果分析，结果提示A组直接医疗成本稍高于B组（25 725.95元vs 25 277.62元，P＝0.914），其中药品费用、检查治疗费、床位护理费A组均高于B组，差异无统计学意义。结论 美罗培南和头孢哌酮/舒巴坦治疗产ESBLs肠杆菌科细菌血流感染的临床疗效和安全性相当，头孢哌酮/舒巴坦稍有经济优势。

Objective To compare the cost and efficacy of meropenem and cefoperazone/sulbactam in the treatment of ESBLs producing Enterobacteriaceae bacterial bloodstream infections, and provide reference for rational drug use. Methods A retrospective statistical analysis was conducted on the medical records of patients with ESBLs and Enterobacteriaceae bloodstream infections in BinHu District of Hefei First People's Hospital from January 2020 to May 2022. Based on comprehensive consideration of treatment efficacy and adverse drug reactions, cost-minimization analysis method was used for pharmacoeconomic evaluation. Results A total of 67 cases and 68 cases of ESBLs producing Enterobacteriaceae bacterial bloodstream infections were collected in the treatment with meropenem (group A) and cefoperazone/sulbactam (group B), respectively. There was no significant difference in the general situation between the two groups. After treatment with antibiotics, there was no significant difference in the effective rate (95.52% vs 98.53%, P = 0.303) and bacterial clearance rate (95.52% vs 97.06%, P = 0.636) between the two groups. After discontinuation of the two antibacterial drugs, the CRP indicators were 5.97 and 6.82 mg · L^-1, respectively (P = 0.391), and the PCT indicators were 0.29 and 0.21 ng·mL^-1, respectively (P = 0.228), with no statistically significant difference in the inflammatory indicators. There was no significant difference in the recovery time of body temperature and white blood cell, duration of antimicrobial treatment and length of hospital stay between the two groups. Neither treatment group had serious adverse reactions. Therefore, a cost-effectiveness analysis was conducted using the cost-minimization analysis method for both groups. The results showed that the direct medical cost of the meropenem group was slightly higher than that of the cefoperazone/sulbactam group (25 725.95 yuan vs 25 277.62 yuan, P = 0.914), while the drug costs, the examination and treatment costs and the nursing and bed expenses of the Meropenem group were all higher than those of the cefoperazone/sulbactam group, and the difference was not statistically significant. Conclusion The clinical efficacy and safety of meropenem and cefoperazone/sulbactam in the treatment of producing ESBLs bloodstream infection were comparable, while cefoperazone/sulbactam had slight economic advantages.

R978.1