摘要
目的:探讨真实世界中,实施利奈唑胺治疗药物监测(TDM)对其抗感染疗效、血液系统不良反应和经济性的影响。方法:选取2017年6月–2021年11月我院使用利奈唑胺的389例患者资料,经倾向性评分匹配后分为TDM组(163例)和非TDM组(163例),两组均使用利奈唑胺600 mg,q 12 h,ivgtt,TDM组在此基础上进行治疗药物监测。评估两组抗感染效果、血小板减少和血红蛋白减少发生情况,比较两组患者临床成本-效果比和抗菌药物成本-效果比。结果:TDM组有效率显著高于非TDM组(84.66%vs 65.64%,P<0.001);TDM组血小板减少发生率显著低于非TDM组(9.20%vs 17.18%,P<0.05);TDM组血红蛋白减少发生率显著低于非TDM组(7.98%vs 15.34%,P<0.05);TDM组患者临床成本-效果比与抗菌药物成本-效果比均小于非TDM组(P<0.05),TDM组经济性更佳,每提高一个疗效单位,TDM组患者较非TDM组患者治疗费用可节省1487.01元。结论:使用利奈唑胺的患者基于TDM个体化给药有助于提高临床疗效,降低血小板和血红蛋白减少的发生率,减轻患者经济负担。
Objective:To explore the effects on the anti-infective efficacy,hematological adverse reactions and economy of linezolid therapeutic drug monitoring(TDM)in the real world.Methods:389 patients who used linezolid in our hospital from June 2017 to November 2021 were divided into TDM group(163 cases)and non-TDM group(163 cases)after the propensity score matching.Both groups of patients were treated with linezolid(600 mg,q 12 h,ivgtt)and TDM group was monitored on this basis.The anti-infection effect,thrombocytopenia and hemoglobin reduction of the two groups of patients were evaluated.The clinical cost-effectiveness ratio and cost-effectiveness ratio of antibacterial drugs between the two groups were compared.Results:The clinical effective rate of the TDM group was significantly higher than that of the non-TDM group(84.66%vs 65.64%,P<0.001).The incidence of thrombocytopenia and hemoglobin reduction in the TDM group was significantly lower than those in the non-TDM group(9.20%vs 17.18%and 7.98%vs 15.34%respectively,P<0.05).The clinical cost-effectiveness ratio and cost-effectiveness ratio of antibacterial drugs of the TDM group were both significantly lower than those in the non-TDM group(P<0.05).The economic efficiency of the TDM group was relatively better than that in the non-TDM group.The treatment cost of the TDM group could save 1487.01 yuan compared with that of the non-TDM group by increasing one efficacy unit.Conclusion:Individualized administration of linezolid based on TDM could improve the clinical efficacy,reduce the incidence rate of thrombocytopenia and hemoglobin reduction and the economic burden of patients.
作者
自雪梅
张峻
何瑾
ZI Xue-mei;ZHANG Jun;HE Jin(Department of Clinical Pharmacy,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)
出处
《中国药物应用与监测》
CAS
2023年第1期1-4,共4页
Chinese Journal of Drug Application and Monitoring
基金
云南省高层次卫生技术人才培养专项经费资助项目(D-2018042)
云南省基础研究计划(昆明医科大学联合专项)项目(202101AY070001-091)。
关键词
利奈唑胺
治疗药物监测
有效性
血液系统不良反应
经济性
Linezolid
Therapeutic drug monitoring
Effectiveness
Hematological adverse reaction
Economy
