A 1year retrospective audit of quality indicators of clinical pharmacological advice for personalized linezolid dosing: one stone for two birds?

作者：Pea Federico^*; Cojutti Piergiorgio; Dose Lucia; Baraldo Massimo

来源：British Journal of Clinical Pharmacology, 2016, 81(2): 341-348.

DOI：10.1111/bcp.12806

• clinical pharmacological advice
• cost balance analysis
• linezolid
• therapeutic drug monitoring

AimThis 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.
MethodsA 1year 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.
ResultsFive 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 600mg) were spared for treating 168 patients with a personalized dosage for a median duration of 11days (range 3-128days) with a cost saving of 60038.05 Euro.
ConclusionActive 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.

• 出版日期2016-2