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2015 ; 4
(3
): 309-20
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Antimicrobial Stewardship Intervention and Feedback to Infectious Disease
Specialists: A Case Study in High-Dose Daptomycin
#MMPMID27025626
Ross JL
; Rankin S
; Marshik P
; Mercier RC
; Brett M
; Walraven CJ
Antibiotics (Basel)
2015[Jul]; 4
(3
): 309-20
PMID27025626
show ga
Infectious Diseases specialists have used high-dose daptomycin (?6 mg/kg/day) in
select patients with difficult to treat methicillin-resistant Staphylococcus
aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) infections to optimize
outcomes. Antimicrobial stewardship programs enforce antimicrobial formulary
restrictions; however, interventions specifically aimed at Infectious Disease
specialists can be particularly challenging. The purpose of this study was to
create a high-dose daptomycin algorithm for Infectious Disease specialists that
are consistent with best-practices. Daptomycin prescribing habits pre- and
post-daptomycin algorithm implementation were evaluated using a
quasi-experimental study design. Patients were included if ?18 years of age and
received daptomycin for ?48 h. Patients were excluded if daptomycin was initiated
on an outpatient setting. During the 12-month pre-intervention phase, 112
patients were included, with 73 patients in the 12-month post-intervention phase.
A statistically significant decrease in the mean daptomycin dose from 9.01 mg/kg
to 7.51 mg/kg (p < 0.005) was observed, resulting in an annual drug cost-savings
of over $75,000 without adversely affecting readmission rates due to infection.
Creation of a daptomycin algorithm with consideration of pathogen, disease state,
and prior treatment, is an effective means of influencing prescribing habits of
Infectious Disease specialists.