Evaluation of glycopeptide prescription and therapeutic drug monitoring at a university hospital.
The aim of this study was to assess the appropriateness of glycopeptide prescription almost 15 y after the publication of the Hospital Infection Control Practices Advisory Committee (HICPAC) guidelines. We also assessed the adequacy of dose regimen and therapeutic drug monitoring (TDM). All glycopeptide prescriptions were collected during a 3-month prospective study and evaluated by 2 independent infectious diseases experts. Appropriateness of prescription was assessed according to local guidelines based on the HICPAC recommendations. A total of 154 prescriptions were evaluated: 77% (69.1-83.0) were appropriate and 36% (28.2-43.8) were adequate with regard to dose regimen and loading dose. Multivariate analysis showed greater appropriateness for vancomycin than for teicoplanin (p=0.01). There was a wide discrepancy among units (p=0.04). TDM was appropriately performed in 40% (32.3-47.7) of glycopeptide treatments. When required, dose regimen adaptations occurred in 58% of cases. In conclusion, we show a satisfactory appropriateness of glycopeptide prescription. However, the adequacy of dose regimens must be improved. Finally, TDM does not comply with recent recommendations in most cases.
Roustit
Matthieu
M
Service des Maladies Infectieuses, Pôle Médecine Aigue et Communautaire, CHU de Grenoble, Université Joseph Fourier, Grenoble, France.
François
Patrice
P
Sellier
Elodie
E
Roch
Nathalie
N
Vittoz
Jean-Philippe
JP
Foroni
Luc
L
Stahl
Jean-Paul
JP
Pavese
Patricia
P
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D016903:Drug Monitoring / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006020:Glycopeptides / Q000627:therapeutic use*; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006302:Health Services Research; D006785:Hospitals, University; D006801:Humans; D008297:Male; D055656:Prescriptions / Q000706:statistics & numerical data*; D011446:Prospective Studies
D000900:Anti-Bacterial Agents; D006020:Glycopeptides