Cost-Effectiveness Analysis Kloramfenikol Dan Seftriakson Untuk Pengobatan Demam Tifoid Pada Pasien Dewasa Di Rumah Sakit Sanglah Denpasar

Amelia Lorensia, Doddy de Queljoe, Made Dwike Swari Santi
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Abstract

The number of typhoid fever patient in Indonesia is still high. Typhoid fever can be treated by antibiotic therapy such as chloramphenicol and ceftriaxone. The purpose of this study was to compare the cost-effectiveness of chloramphenicol and ceftriaxone which was given to adult patients who were diagnosed with typhoid fever in Sanglah Denpasar Hospital. A comparative study between two alternatives was conducted using the hospital perspective. Retrospective method was used to collect data from patient medical records, who was diagnosed and hospitalized in Sanglah Denpasar Hospital during January 2017 until July 2018. The cost analysis was perform using cost-effectiveness grid and cost-effectiveness ratio (ACER) methods. Cost-effectiveness grid showed that dominant of ceftriaxone for patient with typhoid fever. ACER analysis for ceftriaxone was IDR 2,097,170.88 with effectivenes (length of stay) 4.27 days, and was IDR 2,097,170.88 with effectiveness (the time of reaching normal temperature) 2.42 days. ACER analysis for chloramphenicol was IDR 2,555,464.22        with effectivenes (length of stay) 10.22 days, and was IDR 2,555,464.22 with effectiveness (the time of reaching normal temperature) 3.44 days. ACER analysis showed lower degree of ceftriaxone and higher effectiveness based on length of stay and the time of reaching normal temperature. The conclusion of this study is that ceftriaxone is more cost-effective than chloramphenicol.
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印度尼西亚的伤寒患者人数仍然很高。伤寒可以用抗生素治疗,如氯霉素和头孢曲松。本研究的目的是比较在Sanglah Denpasar医院诊断为伤寒的成年患者给予氯霉素和头孢曲松的成本-效果。从医院的角度对两种方案进行了比较研究。采用回顾性方法收集2017年1月至2018年7月在Sanglah Denpasar医院诊断和住院的患者病历数据。采用成本效益网格和成本效益比(ACER)方法进行成本分析。成本-效果网格显示,头孢曲松在伤寒患者中占主导地位。头孢曲松的ACER分析为2097170.88印尼盾,有效时间(停留时间)为4.27天;氯霉素的ACER分析为2,555,464.22 IDR,有效(停留时间)10.22 d; 2,555,464.22 IDR,有效(达到常温时间)3.44 d。ACER分析显示,头孢曲松的治疗程度较低,而根据住院时间和达到正常体温的时间,头孢曲松的疗效较高。本研究的结论是头孢曲松比氯霉素更具成本效益。
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