在患有败血症的住院患者中,以公素为导向的抗生素持续时间的成本效益
Matt Stevenson1, Jessica E Forsyth2, Anower Hossain3
1Sheffield Centre for of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK. m.d.stevenson@shef.ac.uk.
Critical care (London, England)
|November 29, 2025
概括
在重症成年人中,以前素 (PCT) 指导的抗生素治疗败血症可能是具有成本效益的. 对PCT测试的适度成本增加可以改善抗生素管理和患者的结果.
科学领域:
- 关键护理医学 关键护理医学
- 卫生经济学 卫生经济学
- 传染性疾病 传染性疾病
背景情况:
- 严重病情严重的成年人中败血症的管理通常涉及长期使用抗生素.
- 普罗卡尔西托尼 (PCT) 指导的方案提供了一个精确的医疗方法,以优化抗生素的持续时间.
- 在重症监护中PCT引导性败血症治疗的成本效益数据有限.
研究的目的:
- 评估成年败血症患者每日PCT指导方案对抗生素治疗持续时间的成本效益.
- 为了比较PCT指导的方法与标准护理和C-反应蛋白 (CRP) 指导的协议.
主要方法:
- 经济评价使用ADAPT-败血症研究 (2760名患者) 的数据.
- 两个分析:ADAPT-Sepsis数据和来自多个PCT研究的分析数据.
- 测量的主要结果:每QALY获得的成本,抗生素日,住院/ICU,死亡率和PCT测试.
主要成果:
- ADAPT-Sepsis数据显示,PCT指导 (每名患者增加427欧元) 导致QALY损失很小,这表明标准护理占主导地位.
- 分析后的数据表明,PCT指导 (每名患者增加330欧元) 获得了0.139个QALY,每次QALY的成本为2384.4欧元.
- 如果只有抗生素使用和PCT测试有所不同,那么成本是适度的 (每患者110欧元),QALYs相同.
结论:
- 在败血症中使用抗生素持续时间的PCT指导协议可能具有成本效益.
- 与PCT测试相关的适度成本增加可以证明改善抗生素管理是合理的.
- 这种方法为严重病情的成人败血症患者提供了一个潜在的有价值的策略.
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