在西班牙,针对重症患者的个性化抗微生物剂量优化的经济影响
Santiago Grau1,2, Sonia Luque1, Olivia Ferrandez1,2
1Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.
在重症患者中,抗微生物治疗药物监测 (TDM) 可能会增加治愈率. 然而,与没有监测相比,其经济影响仍然是不确定的,因为数据不尽相同.
科学领域:
- 药理学 药理学是指药理学的学科.
- 卫生经济学 卫生经济学
- 关键护理医学 关键护理医学
背景情况:
- 对重症患者来说,个性化抗微生物剂量至关重要.
- 治疗药物监测 (TDM) 旨在优化抗菌药物治疗.
- 在这个人群中,TDM的经济影响需要进行彻底的评估.
研究的目的:
- 估计抗微生物TDM对西班牙没有监测的经济影响.
- 在重症患者中比较TDM的成本效益.
主要方法:
- 使用概率马尔科夫模型与二级蒙特卡洛模拟进行成本分析.
- 基于已发表的元分析 (Pai Mangalore, 2022; Sanz-Codina, 2023; Takahashi, 2023) 分析了三个不同的场景.
主要成果:
- 在一项分析中,TDM导致每位患者的支出为195欧元,但在另外两项分析中节省了-301欧元和-685欧元.
- 在不同分析中,TDM产生节约的概率差异很大 (39.4%至79.7%).
- 差异归因于方法上的差异,特别是与TDM相关的治愈率 (12.2%16.6%的增加).
结论:
- 在接受抗微生物治疗的重症患者中,TDM增加了治愈的可能性.
- 虽然TDM的经济影响可能是有益的,但目前的数据尚未确定.
- 需要进一步的研究来澄清TDM在这个患者群体中的成本效益.
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