OBJECTIVE To address the complexity of selecting antimicrobial agents for the treatment of bloodstream infections caused by resistant Gram-positive bacteria, a multi-criteria decision-making model based on the AHP was constructed to conduct a comprehensive evaluation, thereby providing data-driven support for clinical decision-making.
METHODS An AHP model was constructed using multiple evaluation criteria: pharmacodynamics(e.g., MIC values), pharmacokinetics(e.g., tissue penetration, half-life), safety(e.g., ADR incidence, hepatic/renal toxicity), economics(e.g., DDD cost, defined daily dose cost), and accessibility(e.g., supply stability, medical insurance coverage). Analysis was performed using Matlab R2014a software.
RESULTS The contribution weights of ceftobiprole, vancomycin, linezolid, and daptomycin to the optimal antimicrobial selection were 0.2423, 0.2249, 0.2074 and 0.3254, respectively. The composite consistency index(CI*) was 0.0430, and the composite consistency ratio(CR*) was 0.0478(<0.1), meeting the consistency test criterion.
CONCLUSION The constructed AHP model passes the consistency test, and the comprehensive evaluation results indicate that ceftobiprole can be considered as a new treatment option for MRSA bloodstream infections, with efficacy second only to daptomycin, while vancomycin may serve as an alternative. It should be noted that these findings are for reference only.
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