Briceland L L, Nightingale C H, Quintiliani R, Cooper B W
Department of Pharmacy Practice, Albany College of Pharmacy, NY 12208.
Am J Hosp Pharm. 1988 May;45(5):1082-5.
A multidisciplinary cost-containment program for promoting less frequent administration of mezlocillin injection is described. The pharmacy department and the division of infectious diseases at Hartford Hospital implemented a program through which regimens of mezlocillin 5 g every eight hours would automatically be substituted for the frequently prescribed regimen of mezlocillin 3 g every four hours. Patients with urinary-tract infections or renal insufficiency and febrile neutropenic cancer patients also received various modified regimens. Use of the modified regimens was promoted through inservice education programs and distribution of newsletters and pocket-size brochures describing the dose-dependent pharmacokinetics of mezlocillin to medical staff. The pharmacy and therapeutics committee supported the program by endorsing the use of the modified regimens and distributing periodic progress reports. Pharmacists on the nursing units were responsible for enforcing the program stipulations regarding modified dosage regimens and for reporting adverse reactions and unexpected therapeutic failures. Ten months after implementation of the program, there was better than 99% compliance with the appropriately modified mezlocillin dosage regimens. Theoretical annual cost savings based on less frequent administration of mezlocillin injection amount to more than $33,000. The multidisciplinary program described here was successful in promoting the use of modified mezlocillin dosage regimens.
本文描述了一个旨在促进减少美洛西林注射给药频率的多学科成本控制项目。哈特福德医院的药剂科和传染病科实施了一项计划,通过该计划,每八小时一次的5克美洛西林给药方案将自动替代常用的每四小时一次的3克美洛西林给药方案。患有尿路感染或肾功能不全的患者以及发热性中性粒细胞减少的癌症患者也接受了各种调整后的给药方案。通过在职教育项目以及向医务人员分发时事通讯和袖珍手册来推广调整后给药方案的使用,这些手册描述了美洛西林的剂量依赖性药代动力学。药学与治疗学委员会通过认可调整后给药方案的使用并分发定期进展报告来支持该项目。护理单元的药剂师负责执行关于调整剂量方案的项目规定,并报告不良反应和意外的治疗失败情况。该项目实施十个月后,对调整适当的美洛西林给药方案的依从性超过99%。基于减少美洛西林注射给药频率的理论年度成本节省超过33,000美元。本文所述的多学科项目成功促进了调整后的美洛西林给药方案的使用。