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A 1 year retrospective audit of quality indicators of clinical pharmacological advice for personalized linezolid dosing: one stone for two birds?
Author(s) -
Pea Federico,
Cojutti Piergiorgio,
Dose Lucia,
Baraldo Massimo
Publication year - 2016
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.12806
Subject(s) - linezolid , medicine , dosing , retrospective cohort study , clinical audit , intensive care medicine , emergency medicine , audit , management , economics , staphylococcus aureus , vancomycin , biology , bacteria , genetics
Aim This study explored the clinical and economic impact of clinical pharmacological advice (CPA) (based on therapeutic drug monitoring [TDM] results, and on patients' characteristics and co‐medications) on personalized linezolid therapy in a tertiary care hospital. Methods A 1 year retrospective analysis of quality indicators of CPA (clinicians' adherence rate to CPA, pre‐post rate of linezolid trough concentrations within the desired range and cost balance analysis) was conducted. Results Five hundred and forty‐four CPAs were provided to clinicians during 2014 for personalizing linezolid therapy in 168 patients. Clinicians' adherence to CPAs was very high (94.7%). The pre‐post rate of linezolid C min distribution showed a favourable impact of CPA on patient care (pre‐post ratio of C min within the desired range + 23.4%, pre, 51.2% vs . post, 74.6%). Overall, linezolid dosage was mainly reduced (56.9% of cases), whereas dose augmentation was needed only in a minority of cases (7.7%). Cost balance analysis showed that overall 1258 standard doses of linezolid (unitary dose 600 mg) were spared for treating 168 patients with a personalized dosage for a median duration of 11 days (range 3–128 days) with a cost saving of 60038.05 €. Conclusion Active computerized advice elaborated by the clinical pharmacologist on the basis of TDM results and of patient's pathophysiological data and co‐medications may be cost‐effective for personalizing linezolid treatment.