Background Increasingly frequent and inappropriate prescription of broad-spectrum antibiotics justifies the use in first-line treatment of effective antibiotics such as glycopeptides and aminoglycosides, whose use was abandoned because of their associated adverse effects.
Purpose To analyse the degree of implementation of the recommendations of dose setting, by monitoring pharmacokinetics in antibiotic treatments in follow-up by the Spanish PROA Group (Optimisation Antibiotics PRogram).
Material and methods Observational and retrospective study on the Unit of Clinical Pharmacokinetics () from a university hospital during a period of 6 months (December 2016 to May 2017). Antibiotics glycopeptides (vancomycin) and aminoglycosides (gentamicin, tobramycin and amikacin) were the monitored drugs. For the processing of the information, standard sheets of application of plasma levels and reports made by the UFCC in the corporate application Diraya® (Digital single story) were reviewed. Both paediatric and adult populations were considered and the collected parameters were: dosage (mg/hour), weight (kg), size (cm), the infusion duration (min), age (years/days), days of treatment, the time of extraction, Cmin (trough level) and Cmax (peak level) (mcg/ml).
Results The data of 123 adults were collected (63.4% male), with an average age of 46 years and range (16–91). The paediatric population consisted of 21 patients (12 females) with ages ranging from 2 days to 1.5 months. The average duration of treatment for adults was 17 days and 5 days for infants. A subset of 13 patients in haemodialysis (HD) (61.5% female) was also analysed.
Seven hundred and twenty-two determinations of plasma levels, putting on average three to five monitors per adult patient in the paediatric information were sought . Seventy-eight per cent (563) of dosing adjustments were vancomycin and 22% (159) remaining of aminoglycosides, being the most sought-after gentamicin.
Requests for levels distributed services was : infectious diseases (48%), ICU (22%), internal medicine (17%) and paediatrics (13%). Of the total of monitors, 2.9% (21) could not be performed due to lack of information or incorrect data in the application.
Conclusion Of 217 recommended individualised dosing adjustments, 209 were accepted (96.3%), which allowed the use of these antibiotics in the first instance, preserving ecological niches and reducing the economic impact.
References and/or Acknowledgements Thanks to the PROA working group and the rest of the clinicians who have made this work possible
No conflict of interest
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