Abstract: Objective  To explore the efficacy comparison and cost-effectiveness analysis of different administration frequency of ceftazidime for complicated urinary tract infections(UTI).
Methods  A total of 153 patients with complicated UTI admitted to the Department of Nephrology were randomly divided into groups A, B, and C, with 51 cases in each group. Group A was given 1 g of ceftazidime for injection by intravenous infusion every 12 h, group B was given 1 g of ceftazidime for injection intravenously every 8 h, and group C was given 2 g of ceftazidime for injection intravenously every 12 h. Each group was treated for 1 week as a course of treatment. The clinical efficacy, laboratory examination, negative conversion rate of midstream urine bacteria culture and adverse reaction rate of the three groups were observed. The pharmacoeconomics of three treatment schemes was evaluated by cost-effectiveness analysis.
Results  There was no statistically significant difference in the total effective rate of the three groups in terms of clinical efficacy(P＞0.05); the rank sum test showed that the difference in the clinical efficacy of the three groups was statistically significant(P＜0.05). The time to clinical symptom resolution, negative conversion time of white blood cell in urine test and antifebrile time were significantly shorter in group B than in group A and group C, and shorter in group C than in group A(P＜0.05). After treatment, the levels of procalcitonin(PCT), interleukin-6(IL-6), serum hypersensitive C-reactive protein(hs-CRP) and interleukin-8(IL-8) in three groups were significantly decreased(P＜0.05), among which the level of group B was the lowest, followed by group C, and group A. The negative conversion rate of midstream urine bacteria culture was 88.24% in group A, 94.12% in group B and 90.20% in group C. The PK/PD compliance rates of ceftazidime in groups A, B, and C were 72.55%, 84.31%, and 76.47%, respectively. There was no statistically significant difference in the incidence of adverse reactions among three groups(P＞0.05). After the cost-effectiveness analysis of the three treatment options, it was concluded that group B had the optimal treatment options. The results of incremental cost-effectiveness analysis in the three groups showed that, according to the advantages of group B, if the drug price dropped by 15%, the results of sensitivity analysis supported the cost-effectiveness analysis results.
Conclusion  The optimal clinical efficacy can be achieved at a dose of 1g ceftazidime and administration frequency of every 8 h, when the body's inflammatory response is significantly reduced, and the time to clinical symptom resolution, negative conversion time of white blood cell in urine test and antifebrile time are the shortest, with the highest negative conversion rate of urine culture. Therefore, it is the optimal treatment plan.

Key words: urinary tract infections, ceftazidime, treatment outcome