antibioticsАнтибиотики и ХимиотерапияAntibiot Khimioter = Antibiotics and Chemotherapy0235-2990ООО «Издательство ОКИ»antibiotics-354Research ArticleВ ПОМОЩЬ ПРАКТИКУЮЩЕМУ ВРАЧУGUIDELINES FOR PRACTITIONERSКлинико-экономическая целесообразность применения эртапенема для лечения пациентов с осложнёнными инфекциями мочевыводящих путейClinical and Economic Expedience of Ertapenem Therapy of Complicated Urinary Tract InfectionКолбинА. С.KolbinA. S.noemail@neicon.ruСидоренкоС. В.SidorenkoS. V.noemail@neicon.ruЗагородниковаК. А.ZagorodnikovaK. A.noemail@neicon.ruМусатовВ. Б.MusatovV. B.noemail@neicon.ruЯковлевА. А.YakovlevA. A.noemail@neicon.ruСанкт-Петербургский государственный университетРоссияSt.Petersburg State UniversityRussian FederationНаучно-исследовательских институт детских инфекций, Санкт-ПетербургРоссияResearch Institute of Children's Infections, St.PetersburgRussian Federation201113052020561-23542Copyright © ООО «Издательство ОКИ», 20202020ООО «Издательство ОКИ»ООО «Издательство ОКИ»https://www.antibiotics-chemotherapy.ru/jour/about/submissions#copyrightNoticehttps://www.antibiotics-chemotherapy.ru/jour/article/view/354

В российских экономических условиях при помощи методов математического моделирования проведено клинико-экономическое исследование использования различных антибактериальных препаратов при лечении осложнённых инфекций мочевыводящих путей (ОИМВП). Препаратами сравнения были эртапенем, цефтриаксон и левофлоксацин. Показаны прямые затраты, их структура, рассчитана эффективность затрат. Проведён альтернативный анализ и односторонний анализ чувствительности. Выявлено, что при осложнённых инфекциях мочевыводящих путей, при которых возбудителями являются Escherichia coli, Klebsiella pneumoniae и Proteus mirabilis, с клинико-экономических позиций целесообразнее начинать лечение с цефтриаксона или эртапенема, а альтернативным средством может быть левофлоксацин. При оценке влияния приобретённой бактериальной антибиотикорезистентности на эффективность лечения (SIS модель) показано, что чувствительность бактериальных возбудителей к эртапенему сохраняется значимо дольше, чем к цефтриаксону или левофлоксацину. Данный показатель может являться дополнительным обоснованием целесообразности применения эртапенема как стартовой терапии ОИМВП.

Clinical and economic investigation of various antibiotics use in the treatment of complicated urinary tract infection (CUTI) was performed under the Russian economic environment. The drugs of comparison were ertapenem, ceftriaxone and levofloxacin. Direct costs and their structure were shown, and the cost efficiency was calculated. Alternative analysis and one-side susceptibility analysis were performed. In complicated urinary tract infections when the major pathogens were Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis it was clinically and economically reasonable to start the treatment with ceftriaxone or ertapenem, while levofloxacin could be an alternative strategy. When the effects of the acquired resistance on the treatment effectiveness were evaluated (SIS model) it was shown that the pathogens susceptibility to ertapenem was preserved for a significantly longer time than that to ceftriaxone or levofloxacin (60 months). Such a parameter may serve as an additional evidence of the reasonable use of ertapenem as the starting treatment of CUTI.

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The authors declare that there are no conflicts of interest present.