Pharmacist-Driven Dosing Services and Pharmaceutical Care Increase Probability of Teicoplanin Target Concentration Attainment and Improve Clinical and Economic Outcomes in Non-Critically Ill Patients

• Published in: Infectious diseases and therapy Vol. 12; no. 6; pp. 1579 - 1592
• Main Authors: Chen, Dayu, Wen, Bo, Wu, Xuanyu, Zheng, Xinxin, Zhu, Huaijun, Chen, Xingkai, Han, Dan, Liu, Jinchun, Liu, Yunxing, Guo, Jiayue, Zhu, Shaoshi, Ren, Haozhen, Ge, Weihong, Zhang, Haixia
• Format: Journal Article
• Language: English
• Published: Cheshire Springer Healthcare 01.06.2023; Springer; Springer Nature B.V; Adis, Springer Healthcare
• Subjects: Antibiotics; ChiCTR; ChiCTR2000033521; China; Clinical outcomes; Clinical pharmacist; Costs; Drug dosages; Drug stores; Economic aspects; Gram-positive bacteria; Hospitals; Infection; Infections; Infectious Diseases; Internal Medicine; Medical care, Cost of; Medical colleges; Medical research; Medical schools; Medicine; Medicine & Public Health; Medicine, Experimental; Mortality; MRSA; Non-critically ill patients; Original Research; Patient outcomes; Pharmaceutical care; Pharmaceutical industry; Pharmaceuticals; Pharmacists; Sepsis; Septic shock; Teicoplanin; Therapeutic drug monitoring; China; Therapeutic drug monitoring; Pharmaceutical care; Clinical pharmacist; Teicoplanin; Non-critically ill patients; MRSA
• ISSN: 2193-8229; 2193-6382
• DOI: 10.1007/s40121-023-00812-2

Introduction Pharmacist-driven (PD) dosing and monitoring services have been shown to improve the clinical and economic outcomes in patients treated with different antibiotics, other than teicoplanin. This study investigates the impact of PD dosing and monitoring services on the clinical and economic outcomes of non-critically ill patients receiving teicoplanin treatment. Methods A single-center retrospective study was conducted. Patients were divided into the PD group and the non-PD (NPD) group. Primary outcomes included the achievement of target serum concentration, and a composite endpoint of all-cause mortality, intensive care unit (ICU) admission, and sepsis or septic shock development during hospitalization or within 30 days of hospital admission. The cost of teicoplanin, overall medication cost, and total cost during hospital stay were also compared. Results A total of 163 patients from January to December 2019 were included and assessed. Seventy patients were assigned to the PD group and 93 to the NPD group. The PD group had a higher percentage of patients reaching the target trough concentration (54% versus 16%, p  < 0.001). Around 26% of the patients in the PD group and 50% of the patients in the NPD group met the composite endpoint during their hospital stay ( p  = 0.002). The PD group exhibited a significantly lower incidence of sepsis or septic shock, shorter hospital stays, reduced drug costs, and lower total expenses. Conclusions Our study demonstrates that pharmacist-driven teicoplanin therapy can improve the clinical and economic outcomes for non-critically ill patients. Trial registration : https://www.chictr.org.cn ; identifier, ChiCTR2000033521.