GM-031 Implementation of a standard operative procedure for the clinical pharmacokinetic monitoring of vancomycin

Background Although antibiotics use should be based on fighting hospital infection rates and not primarily on economics, the important decrease in hospital funding means that economic savings is one of our main concerns. Vancomycin is one of the antibiotic drugs with a better cost effective ratio. Purpose To carry out an economic evaluation of the implementation of a standard operative procedure (SOP) for clinical pharmacokinetic (CPK) monitoring of vancomycin and to evaluate the economic results achieved after inclusion of this service at a tertiary referral hospital. Material and methods An economic expenditure study of vancomycin was conducted during the period January 2015 to December 2015. Subsequently, our economic data were compared with those from another tertiary referral hospital with a similar healthcare population which had an operative CPK service. Afterwards, a bibliographic search was done for the SOP development. After its implementation in January 2016, the results of monitored patients over the next 2 months (February 2016 to April/2016) were gathered. Results The main difference between the two hospitals was the presence of a CPK service. Once implementation of the SOP was concluded, defined daily doses (DDD) during the study period were compared to those from the same period the year before for the same drug form/brand: vancomycin 1g DDD: 532 vs 359 (2015 vs 2016), vancomycin 500 mg DDD: 48.75 vs 111.75. From February 2016 to April 2016, 26 adults and 3 children receiving vancomycin were monitored. After the first PK monitoring, 34.62% of adult patients showed plasma concentration levels within the therapeutic range (62.96% showed plasma levels out of the therapeutic range). None of the paediatric patients had appropriate plasma levels at the first PK monitoring. Economic expenditure in this period was compared with that from February 2015 to April 2015: vancomycin €1842.08 vs €1520.62 (2015 vs 2016, respectively; €321.46 saving). Conclusion The principal inconvenience for higher vancomycin prescriptions was the absence of a CPK service in our hospital, encouraging the development and implementation of the CPK SOP. PK monitoring allows us to optimise the efficacy/safety of vancomycin and to reduce the outbreak of bacterial resistances as well as providing important economic savings. No conflict of interest