Objective To compare the therapeutic efficacy, adverse drug reactions, and economic efficiency between generic and branded meropenem in patients with hospital-acquired pneumonia (HAP) and traumatic brain injury.

Methods A retrospective study was conducted on patients with HAP and traumatic brain injury who received meropenem treatment at Suzhou Municipal Hospital between January 2020 and December 2024. Patients were divided into a generic drug group and a branded drug group based on the type of meropenem used. Propensity score matching (PSM) was used to balance baseline characteristics and to compare the clinical response rate, bacterial eradication rate, and 28‑day mortality rate, incidence of adverse reactions, and drug cost of meropenem between the two groups.

Results A total of 273 patients were enrolled, comprising 103 in the generic drug group and 170 in the branded drug group. After PSM, there were 100 cases in each group. There were no statistically significant differences between the generic drug group and the branded drug group regarding clinical efficacy rate (88.00% vs. 92.00%), bacterial clearance rate (82.03% vs. 87.70%), 28-day mortality rate (8.00% vs. 7.00%), or incidence of adverse reactions (19.00% vs. 17.00%) (P > 0.05). In terms of economic evaluation, cost-minimization analysis showed that the generic group had a significantly lower meropenem drug cost than the branded group (446.40 yuan vs. 4 761.08 yuan, P < 0.001). Results from one-way sensitivity analysis were consistent with the cost-minimization analysis.

Conclusion Generic meropenem demonstrates comparable effectiveness and safety to the branded counterpart in treating patients with HAP and traumatic brain injury, while offering significant economic advantages.

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