CAJ | 학술논문

目的：探讨慢性胆囊炎单病种临床路径预防性使用不同抗菌药物以及不预防性使用抗菌药物在预防感染方面的疗效与药物经济学评价。方法：对预防性使用频率较高的3种抗菌药物（头孢呋辛、头孢替安、头孢西丁）以及不预防性使用抗菌药物的380例诊断为慢性胆囊炎或合并胆囊结石行腹腔镜胆囊切除术并实行慢性胆囊炎临床路径的患者病历进行回顾性分析，比较其疗效，并运用成本-效果分析进行药物经济学评价。结果：4种方案取得的疗效相同，未用抗菌药物组、头孢呋辛组患者的成本-效果比低于头孢替安组、头孢西丁组。结论：慢性胆囊炎单病种临床路径不预防性使用抗菌药物或预防性使用头孢呋辛是较佳方案。
목적：탐토만성담낭염단병충림상로경예방성사용불동항균약물이급불예방성사용항균약물재예방감염방면적료효여약물경제학평개。방법：대예방성사용빈솔교고적3충항균약물（두포부신、두포체안、두포서정）이급불예방성사용항균약물적380례진단위만성담낭염혹합병담낭결석행복강경담낭절제술병실행만성담낭염림상로경적환자병력진행회고성분석，비교기료효，병운용성본-효과분석진행약물경제학평개。결과：4충방안취득적료효상동，미용항균약물조、두포부신조환자적성본-효과비저우두포체안조、두포서정조。결론：만성담낭염단병충림상로경불예방성사용항균약물혹예방성사용두포부신시교가방안。
OBJECTIVE:To evaluate the curative efficacy and pharmacoeconomics of prophylactic antibiotics in the prevention of infections in patients with chronic cholecystitis single disease clinical path .METHODS: The medical records of a total of 380 patients with chronic cholecystitis and ( or) gallstones undergoing cholecystectomy and clinical pathway receiving three common prophylactic antibiotics (cefuroxime, cefotiam, cefoxitin) or not receiving prophylactic antibiotics were analyzed retrospectively , with curative efficacy compared and pharmacoeconomic evaluation performed by means of cost-effectiveness analysis .RESULTS:Similar curative efficacy was noted for the four regimens;however , the cost-effectiveness ratio in patients treated without antibiotics and in those treated with cefuroxime was lower than in those treated with cefotiam or cefoxitin .CONCLUSIONS: It is preferable to treat patients with chronic cholecystitis single disease undergoing clinical path with cefuroxime or without using prophylactic antibiotics .