A cost-minimisation analysis comparing different antibiotic regimens used in treating all-cause bacterial pneumonia in Hong Kong

Abstract

Background: To find out the antibiotic treatment regimens with the lowest cost for all-cause bacterial pneumonia, a study to compare the costs of different antibiotic regimens in the treatment of patients diagnosed with all-cause bacterial pneumonia who required hospitalisation was carried out.

Methodology: This was a multicentre, retrospective study of patient medical records. The primary aim was to examine whether the initial choice of antibiotic had affected the total cost of treatment, while the secondary aim was to find out whether the initial choice of antibiotic had affected the initial treatment failure rates and death rates. A cost-minimisation analysis (CMA) from a public hospital perspective was employed.

Results: A total of 333 patient medical case notes were reviewed. The most commonly prescribed antibiotic regimen was amoxycillin-clavulanate (AC) followed by amoxycillin-clavulanate plus macrolide (ACM) and quinolone (Q). In the study population, no statistical significance could be detected between the mean cost of the three regimens. In the subgroup analysis of patients with a history of chronic obstructive pulmonary disease (COPD) and patients with a history of smoking, the Q regimen appeared to be the least expensive.

Conclusion: In the study population, no significant difference could be identified between the mean cost of the three antibiotic regimens. In a special populations such as patients with a history of COPD and patients with a history of smoking, the Q regimen appeared to be superior. Further studies in these areas are needed.     

Comparative costs of hospitalisation among infants at high risk for respiratory syncytial virus lower respiratory tract infection during the first year of life

Abstract

Objective: This retrospective cohort study compared the total cost of hospitalisation due to respiratory syncytial virus (RSV) lower respiratory tract infection (LRI) during the first year of life between late-preterm (33–36 weeks gestational age [wGA]) and term (≥37 wGA) infants.

Research design and methods: A large national claims database of commercially insured members was examined to identify hospital admissions associated with RSV between January 2003 and June 2007 among infants at high risk for RSV LRI, including late-preterm infants. Hospital use and costs were compared with those of a reference cohort of term infants with RSV.

Results: The cost of hospitalisation for RSV among late-preterm infants with at least one hospital admission associated with RSV (n=173) was twice that of term infants (n=1,983; $20,269 vs. 9,635; p<?0.001). The mean length of stay was also higher (5.3 vs. 3.4 days; p<?0.001). Approximately 21.9% of hospitalisations for late-preterm infants included an intensive care unit admission compared with 9.6% among term infants (p<?0.001).

Limitations: Reliance on ICD-9 codes to identify potential cohort members may result in misclassification and underreporting the cohort size for conditions of interest.

Conclusions: Hospitalisation costs and length of stay due to RSV LRI were significantly greater among late-preterm infants compared with term infants and higher than general estimates previously reported in the broader paediatric population.     

病毒营销:受众带来的威力与风险

互联网的应用使人们不再只是单纯的信息接收者,也成为了信息的发布者。病毒营销正是充分利用了网络受众的自主能动性,其作为网络时代的一种新生营销方式,以低成本、高效率的传播广受商家青睐,本文通过分析受众在病毒营销中的威力和风险,试图为企业的病毒营销运作提供一点参考。     

Literature-related discovery: Potential treatments and preventatives for SARS

Literature-related discovery (LRD) is the linking of two or more previously disjoint concepts in order to produce novel, interesting, plausible, and intelligible connections (i.e., potential discovery). LRD has been used to identify potential treatments or preventative actions for challenging medical problems, among myriad other applications.Severe acute respiratory syndrome (SARS) was the first pandemic of the 21st century. SARS was eventually controlled through increased hygienic measures (e.g., face mask protection, frequent hand washing, living quarter disinfection), travel restrictions, and quarantine. According to recent reviews of SARS, none of the drugs that were used during the pandemic worked.For the present paper, SARS was selected as the first application of LRD to an infectious disease. The main goal of this research was to identify non-drug non-surgical treatments that would 1) prevent the occurrence, or 2) reduce the progression rate, or 3) stop/reverse the progression of SARS. The MeSH taxonomy of Medline was used to restrict potential discoveries to selected semantic classes, and to identify potential discoveries efficiently. To enhance the volume of potential discovery, databases were used in addition to Medline. These included the Science Citation Index (SCI) and, in contrast to previous work, a full text database. Because of the richness of the full text, ‘surgical’ queries were developed that targeted the exact types of potential discovery of interest while eliminating clutter more efficiently.     

病毒性营销策略在网络营销中的应用

病毒性营销策略作为一种网络营销方法已被众多企业接受并实践。它的低成本给企业带来丰厚的收益,但同时实施 过程中也隐藏着风险。文章从病毒性营销策略的涵义入手,在分析了具体的实施工具后,阐述了整个实施过程以及可能的风险 与一些技巧,最后用具体的案例说明如何在网络营销中成功地实施病毒性营销策略。     

阿奇霉素在小儿肺炎中的药代学研究

目的探讨阿奇霉素在小儿肺炎中的药代学特征,据此拟订其用于肺炎患儿的给药方案。方法 100例肺炎患儿口服阿奇霉素(10mg/kg)后,以高效液相色谱法(HPLC)测定患儿体内的血药浓度,采用AIC法结合F检验判别房室模型,DAS药动学程序计算药动学参数。结果药代学符合二室模型(Wi=1/C2,AIC=-7.0296),主要药动学参数为:α=(0.31±0.07)/h,β=(0.05±0.01)/h,Ka=(0.76±0.18)/h,t1/2β=(42.37±9.23)/h,tmax=(4.13±0.62)/h,Cmax=(318.72±36.51)μg/L,AUC0-144=(22.38±3.14)μg·h/ml,AUC0-∞=(24.66±3.27)μg·h/ml。结论肺炎患儿口服阿奇霉素后有典型的药代学特征,对指导临床给药具有重要的意义。     

新布尼亚病毒流行病学及检测方法的研究进展

着重对近期关于新布尼亚病毒基本特性、国内外流行病学特点、检测方法等方面的研究进展进行综述。应用原子力显微镜观测病毒的基本形貌获得相关数据;流行病学方面SFTS病例也陆续在日本、韩国等国家有发现和报道;检测方面除针对病毒不同基因组的荧光定量方法外,还有反转录环介导的等温扩增技术,以及通过将反转录交叉启动扩增和垂直流偶联快速准确的检测该病毒。     

干扰素在儿科的临床应用

目的研究干扰素在儿科中的临床疗效。方法应用重组人干扰素α1b对上呼吸道、水痘、流行性感冒、手足口病、流行性腮腺炎患儿进行治疗,肌肉注射重组人干扰素α1b50～100U/次,每天一次,疗程为3-5天。结果重组人干扰素α1b治疗上呼吸道感染、水痘、流行性感冒、手足口病、流行性腮腺炎的总有效率分别为96.03%、92.08%、94.05%、94.05%、91.08%。有少数患儿出现发热、白细胞减少、血小板减少等异常,停药后即恢复正常,未发生其他明显的副作用。结论干扰素应用简单,疗效确切,且副作用少,在儿科有广泛的应用。     

Why Forward Viral Fashion Messages? The Moderating Roles of Consumers’ Fashion Traits and Message Orientation

Businesses are now using social media as platforms for viral marketing. However, little is known about the motivations, attitudes, and behaviors of fashion consumers who engage with this marketing instrument. This study examines the factors that influence consumers’ use of social media and their behavioral intentions to forward viral fashion messages. An attitudinal model was proposed through the integration of uses and gratification theory and the elaboration likelihood model. Individuals’ fashion trait and message orientations were specified as moderating factors. An online survey was administered to collect data, and 381 college students participated in the study. Hypotheses were tested using structural equation modeling. Findings showed that individuals’ intention to forward a message was affected by favorable functional and expressive attitudes towards the message, while motivations of using social media had only slight effects on individuals’ attitudes. Group comparisons showed significant moderating effects from identified individuals’ fashion trait and message orientation.     

中西医结合治疗急性病毒性心肌炎的临床疗效

目的探讨中西医结合治疗急性病毒性心肌炎的临床疗效。方法选取80例病毒性心肌炎患者,根据治疗方法不同将其分为两组,单纯西药组患者采用常规的西医综合治疗,中西医结合组患者在此基础上加用黄芪注射液,共治疗4周。结果中西医结合组患者总有效率为95.0%,单纯西药组患者总有效率为82.5%,两组比较差异有统计学意义(P<0.05)。结论中西医综合疗法是治疗急性病毒性心肌炎的一种有效措施。