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Clinical Response and Hospital Costs of Therapeutic Drug Monitoring for Vancomycin in Elderly Patients

Cost-effectiveness analysis has been widely used to assess and compare the costs and benefits of a clinical service. The cost-effectiveness of vancomycin therapeutic drug monitoring (TDM) has not been studied in the elderly, who are susceptible to vancomycin-induced adverse effects. This study was p...

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Autores principales: Kim, Yun, Kim, Soohyun, Park, Jinsook, Lee, Howard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8875716/
https://www.ncbi.nlm.nih.gov/pubmed/35207653
http://dx.doi.org/10.3390/jpm12020163
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author Kim, Yun
Kim, Soohyun
Park, Jinsook
Lee, Howard
author_facet Kim, Yun
Kim, Soohyun
Park, Jinsook
Lee, Howard
author_sort Kim, Yun
collection PubMed
description Cost-effectiveness analysis has been widely used to assess and compare the costs and benefits of a clinical service. The cost-effectiveness of vancomycin therapeutic drug monitoring (TDM) has not been studied in the elderly, who are susceptible to vancomycin-induced adverse effects. This study was performed to evaluate if vancomycin TDM is cost-effective in elderly patients in the Republic of Korea. Using the electronic medical records at a tertiary university hospital, we performed a retrospective observational study to evaluate the cost-effectiveness of vancomycin TDM in 850 elderly patients who underwent vancomycin TDM with an appropriate, recommended dosing regimen and 1094 elderly patients who did not. Cost-effectiveness variables such as clinical outcomes and medical expenses were evaluated using univariate and multivariate analyses. The TDM group spent significantly less than the non-TDM group per patient for total medical expenses (by USD 841.40) and medication expenses (by USD 16.70). However, no significant difference was noted between the TDM and non-TDM groups in clinical outcomes such as microbiological cure, prevention of nephrotoxicity, or reduced mortality, irrespective of admission to the intensive care unit. Vancomycin TDM in elderly patients was associated with economic benefits, but not with better clinical outcomes.
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spelling pubmed-88757162022-02-26 Clinical Response and Hospital Costs of Therapeutic Drug Monitoring for Vancomycin in Elderly Patients Kim, Yun Kim, Soohyun Park, Jinsook Lee, Howard J Pers Med Article Cost-effectiveness analysis has been widely used to assess and compare the costs and benefits of a clinical service. The cost-effectiveness of vancomycin therapeutic drug monitoring (TDM) has not been studied in the elderly, who are susceptible to vancomycin-induced adverse effects. This study was performed to evaluate if vancomycin TDM is cost-effective in elderly patients in the Republic of Korea. Using the electronic medical records at a tertiary university hospital, we performed a retrospective observational study to evaluate the cost-effectiveness of vancomycin TDM in 850 elderly patients who underwent vancomycin TDM with an appropriate, recommended dosing regimen and 1094 elderly patients who did not. Cost-effectiveness variables such as clinical outcomes and medical expenses were evaluated using univariate and multivariate analyses. The TDM group spent significantly less than the non-TDM group per patient for total medical expenses (by USD 841.40) and medication expenses (by USD 16.70). However, no significant difference was noted between the TDM and non-TDM groups in clinical outcomes such as microbiological cure, prevention of nephrotoxicity, or reduced mortality, irrespective of admission to the intensive care unit. Vancomycin TDM in elderly patients was associated with economic benefits, but not with better clinical outcomes. MDPI 2022-01-26 /pmc/articles/PMC8875716/ /pubmed/35207653 http://dx.doi.org/10.3390/jpm12020163 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kim, Yun
Kim, Soohyun
Park, Jinsook
Lee, Howard
Clinical Response and Hospital Costs of Therapeutic Drug Monitoring for Vancomycin in Elderly Patients
title Clinical Response and Hospital Costs of Therapeutic Drug Monitoring for Vancomycin in Elderly Patients
title_full Clinical Response and Hospital Costs of Therapeutic Drug Monitoring for Vancomycin in Elderly Patients
title_fullStr Clinical Response and Hospital Costs of Therapeutic Drug Monitoring for Vancomycin in Elderly Patients
title_full_unstemmed Clinical Response and Hospital Costs of Therapeutic Drug Monitoring for Vancomycin in Elderly Patients
title_short Clinical Response and Hospital Costs of Therapeutic Drug Monitoring for Vancomycin in Elderly Patients
title_sort clinical response and hospital costs of therapeutic drug monitoring for vancomycin in elderly patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8875716/
https://www.ncbi.nlm.nih.gov/pubmed/35207653
http://dx.doi.org/10.3390/jpm12020163
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