Abstract: Background　With the rapid development of medical standards，under the premise of ensuring the safety and effectiveness of medication，reducing medical costs as much as possible has become an urgent problem for medical institutions.Therefore，using the principles of pharmacoeconomics to evaluate the costs and corresponding effects of drug treatment as well as the relationship between them has important guiding significance for the selection and formulation of optimal drug regimens.Objective　To carry out the pharmacoeconomic evaluation of cefoperazone/sulbactam and piperacillin/tazobactam in the treatment of pulmonary infection with Acinetobacter Baumannii in order to provide a reference for clinical rational drug use.Methods　A retrospective investigation of 288 patients of pulmonary infection with Acinetobacter Baumannii in the First Affiliated Hospital，School of Medicine，Shihezi University was carried out from 2015 to 2017.According to the antibacterial treatment regime，the cefoperazone/sulbactam group（group A） had 153 patients and the piperacillin/tazobactam group （group B） had 135 patients.The therapeutic effects of the two groups were compared and a decision tree model was constructed for cost-effectiveness analysis.Results　There were no significant differences in white blood cell count （WBC），C-reactive protein （CRP） and procalcitonin （PCT） between the two groups before and after treatment （P>0.05）．The levels of WBC，CRP and PCT in the two groups after treatment were lower than those before treatment （P<0.05）．There were no significant differences in the time for body temperature returned to normal，improvement time for cough and expectoration，and improvement time for chest tightness and shortness of breath between the two groups （P>0.05）．There was no significant difference in the incidence of adverse reactions between the two groups 〔2.0%（3/153）vs 2.2%（3/135），χ2=0.07，P=0.80〕.There was no significant difference in the effective rates of drugs between the two groups 〔group A=83.7%（128/153），group B=82.2%（111/135），χ2=0.11，P=0.75〕.The expected costs of the two groups were 487 564 yuan and 438 737 yuan，and the cost-effectiveness ratio was 5 825 and 5 337.The cost of cefoperazone/sulbactam for each unit of clinical effect was 32 551 yuan more than piperacillin/tazobactam.Conclusion　There is no difference in the efficacy and incidence of adverse reactions of cefoperazone/sulbactam and piperacillin/tazobactam in the treatment of pulmonary infection with Acinetobacter Baumannii，but piperacillin/tazobactam has economic advantages.

Key words: Pulmonary infections, Acinetobacter Baumannii, Anti-bacterial agents, Cefoperazone/sulbactam, Piperacillin/tazobactam, Decision trees

摘要： 背景　随着医疗水平的快速发展，在确保用药安全、有效的前提下，尽可能降低医疗成本成为医疗机构亟须解决的问题。因此，运用药物经济学原理评价药物治疗的成本和效果以及二者之间的关系，对选择和制定最优用药方案具有重要的指导意义。目的　开展头孢哌酮/舒巴坦、哌拉西林/他唑巴坦治疗鲍曼不动杆菌肺部感染的药物经济学评价，为临床合理用药提供参考。方法　回顾性调查2015—2017年石河子大学医学院第一附属医院确诊为肺部感染且痰培养结果为鲍曼不动杆菌的患者288例，根据治疗方案分为头孢哌酮/舒巴坦组（A组）153例和哌拉西林/他唑巴坦组（B组）135例，比较两组治疗效果，构建决策树模型进行成本效果分析。结果　治疗前及治疗后两组患者白细胞计数（WBC）、C反应蛋白（CRP）、降钙素原（PCT）水平比较，差异均无统计学意义（P>0.05）；两组患者治疗后WBC、CRP、PCT水平较治疗前降低（P<0.05）。两组患者体温恢复正常时间，咳嗽、咳痰好转时间，胸闷、气促好转时间比较，差异均无统计学意义（P>0.05）。两组不良反应发生率比较，差异无统计学意义〔2.0%（3/153）与2.2%（3/135），χ2=0.07，P=0.80〕。A组有效率为83.7%（128/153），B组有效率为82.2%（111/135），差异无统计学意义（χ2=0.11，P=0.75）。两组期望成本分别为487 564元和438 737元，成本效果比分别为5 825和5 337，头孢哌酮/舒巴坦每获得1个单位临床效果所需成本比哌拉西林/他唑巴坦多32 551元。结论　头孢哌酮/舒巴坦和哌拉西林/他唑巴坦治疗鲍曼不动杆菌肺部感染的有效率及不良反应发生率无差异，但哌拉西林/他唑巴坦更具有经济学优势。

关键词: 肺部感染, 鲍氏不动杆菌, 抗菌药物, 头孢哌酮/舒巴坦, 哌拉西林/他唑巴坦, 决策树