Efficacy, safety, and Pharmacoeconomics of Three Common Strategies for Pediatric Alopecia Areata Patients: A Retrospective Cohort Study.

Objective: To evaluate and explore the efficacy, safety, and pharmacoeconomics of three common strategies for pediatric alopecia areata. Methods: Chinese pediatric alopecia areata patients meeting the criteria were included and divided into three groups based on the received treatments. The efficacy, adverse events and pharmacoeconomics of these treatments were retrospectively analyzed. Results: Twenty-four pediatric AA patients were recruited in this study. 100% (12/12) of patients from the traditional group achieved SALT100. In the tofacitinib group, 40.0% (2/5) of patients achieved SALT50. 20.0% (1/5) of patients achieved SALT75 and 40.0% (2/5) of patients achieved SALT100. In the MN group, 42.86% (3/7) of patients were non-responders. 14.28 (1/7) of patients achieved SALT75 and 42.86% (3/7) of patients achieved SALT100. The adverse effects (AEs) were mild in all three groups, and none of the patients discontinued the treatments due to the AEs. Comparing the other two groups, the MN treatment would be more time-intensive and more expensive. Conclusion: For newly diagnosed or naive pediatric patients, the traditional treatment was the first-line approach. For long-duration, severe and refractory patients, tofacitinib and microneedling can be alternative options.

Outbreak of colonization by carbapenemase-producing Klebsiella pneumoniae in a neonatal intensive care unit: Investigation, control measures and assessment.

We describe an outbreak of carbapenemase-producing Klebsiella pneumoniae in a neonatal intensive care unit and assess the effect of infection control measures. Our assessment indicates that active surveillance culture is very useful in identifying multidrug-resistant organisms and its prevention from transmission. Besides contact precaution, environment disinfection, good compliance of hand hygiene, and single-room isolation is very important for preventing transmission of carbapenemase-producing K pneumoniae isolates.

Cost-benefit analysis of craniocerebral surgical site infection control in tertiary hospitals in China.

INTRODUCTION: Surgical site infection (SSI) is one of the most common postoperative complications. This study aimed to determine the cost of SSIs and to evaluate whether SSI control can reduce medical costs under the current medical payment system and wage rates in China. METHODOLOGY: Prospective surveillance of craniocerebral surgery was conducted between July 2009 and June 2012. SSI patients and non-SSI patients were matched with a ratio of 1:2. Terms such as medical costs and length of hospital stay were compared between the two groups. Based on the economic loss of hospital infection, which causes additional expenditures and a reduction in the number of patients treated, the benefits of hospital infection control were estimated. The costs of human resources and materials of hospital infection surveillance and control were also estimated. Finally, the cost-benefit rates in different medical contexts and with different SSI-case ratios were calculated. RESULTS: The incidence of SSIs in this study was 4%. SSIs significantly prolonged hospital stay by 11.75 days (95% CI: 6.24-22.52), increased medical costs by US $3,412.48 (95% CI: $1,680.65-$5,879.89). The direct economic loss was $114,903 in a 40-bed ward. The cost of implementing infection control in such a unit was calculated to be approximately $5,555.47 CONCLUSIONS: Under the current fee-for-service healthcare model in China, the control of SSIs can hardly yield direct economic benefits, but can yield social benefits. With the implementation of a total medical cost pre-payment system, SSI control will present a remarkable benefit-cost ratio for hospitals.

[A retrospective study of amphotericin B treatment for invasive fungal infection].

OBJECTIVE: To evaluate the safety, efficacy and economics of amphotericin B for the treatment of deep fungal infection. METHODS: Retrospectively analyze the data from 113 cases with invasive fungal infection, who were treated with amphotericin B. RESULTS: The total efficacy of amphotericin B is above 76%. The incidence of hypokalemia, creatinine (Cr) and blood urea nitrogen (BUN) elevation were 33.6%, 29.0% and 27.4%, respectively. The instant side effect such as fever and etc. was seen in 15.0%. No dead cases and irreversible renal function impairment could be attributed to amphotericin B. The incidence of allergic reaction and other instant reaction declined after amphotericin B manufacture techniques improved. For standard recommended duration from major guidelines, such as infective endocarditis, osteomyelitis and meningitis, the management with amphotericin B should last at least 12 weeks. The cost for treatment with different agents, such as amphotericin B, fluconazole, itraconazole, liposomal amphotericin B (LamB), voriconazole and caspofungin acetate were RMB 4600, 38,000, 99,100, 190,000, 250,000 and 270,000 yuan, respectively. CONCLUSIONS: Amphotericin B is still the most effective agent for anti-fungal treatment. The incidence of allergic reaction and other instant reaction declined after amphotericin B manufacture techniques improved. Most patients can finish the treatment and be cured. Among all the anti-fungal agents, amphotericin B is still the most cost-effective medicine, especially for the patients who need long time treatment.