[Use of non-conventional amphotericin B at the San Carlos Clinical Hospital].
BACKGROUND
Amphotericin B is the treatment of choice for systemic fungal infections, however, its clinical usefulness is limited by its toxicity. The lipid formulations appear to be equally effective and safer, but are more costly. The increase in the consumption of, and expenditure on these formulas led us to undertake a study in order to identify their profile of use (quantitative and qualitative) and to assess the financial repercussions when used inappropriately.


METHODS
A set of rules were developed for the use of amphotericin B, and the quality of the prescription of non-conventional amphotericin B (amphotericin B notC) was evaluated retrospectively together with the financial repercussions of its inappropriate use.


RESULTS
In 54% of the treatments studied, a poor selection of amphotericin B was made; in 3.5%, the use of amphotericin B was not indicated. The excess expenditure derived from the inappropriate use amounted to 42 million pesetas, 35% of the total expenditure on medicines; the expenditure due to unnecessary prescription was 1,720,327 pesetas.


CONCLUSIONS
The retrospective evaluation has shown that there is a high percentage of treatments that do not conform with the recommendations contained in the prescription rules. The holding of information sessions would assist in achieving a more efficient selection of the amphotericin B notC; this would improve prescription quality, which might also deliver significant financial savings.
Prieto Yerro
C
C
Servicio de Farmacología Clínica, Hospital Clínico de San Carlos, Madrid. conchapy@hotmail.com
Vargas Castrillón
E
E
Laredo Velasco
L
L
Pérez-Cecilia
E
E
Ambit Avila
M I
MI
Picazo de la Garza
J J
JJ
D000666:Amphotericin B / Q000191:economics / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000191:economics / Q000627:therapeutic use*; D002626:Chemistry, Pharmaceutical; D016527:Drug Costs; D004363:Drug Utilization; D006801:Humans; D009181:Mycoses / Q000188:drug therapy*; D012189:Retrospective Studies; D013030:Spain
D000935:Antifungal Agents; D000666:Amphotericin B