Background We analysed teicoplanin prescriptions due to the increase of pharmaceutical interventions.

Purpose To evaluate the real use of teicoplanin in our hospital, check the agreement of prescriptions with the recommendations and standardise prescribing.

Material and methods Over 2 months, we analysed every teicoplanin prescription. We identified:

• Patient information (age, sex, weight and renal clearance)

• Prescription information (indication, dose, antibiogram, teicoplanin serum concentration, dose adjustment).

The correct standard used for patients with normal renal function was the PILLY recommendations. For patients with renal failure, the correct standard used was “Guide de Prescription et Rein” recommendations.

Results 22 patients were included: 12 men and 10 women; 8 had renal failure. 63.6% of the indications were documented (100% of the antibiograms indicated sensitive organisms), 31.8% were probabilistic and 4.6% were prophylactic. 17 patients had teicoplanin serum concentrations tested but only 10 were done on to right date (i.e. just before the 5th injection). For patients with normal renal function, the initial dose was correct for 10 prescriptions and didn’t follow the recommendation for 3 prescriptions (the effectiveness threshold wasn’t reached for 1 serum concentration). The dose adjustment was correct for 6 prescriptions, non-compliant for 3 prescriptions and 4 prescriptions were stopped. For patients with renal failure, the initial dose was correct for 4 prescriptions and non-compliant for 4 prescriptions (efficacy threshold wasn’t reached for 2 serum concentrations). The dose adjustment was non-compliant for 7 prescriptions and 1 prescription was stopped.

Conclusion Finally therapeutic drug monitoring was performed but not correctly. The doses were not always adjusted. It appeared necessary to follow patients with renal failure. As a result of this analysis, we set up a typical prescription summing up the main indications, initial dose, therapeutic drug monitoring recommendations, dose adjustment based on the serum concentration and on renal function.

References and/or acknowledgements No conflict of interest.