Impact of the pharmacist's request for vancomycin dosage in a university hospital: observational study

Abstract

Objective: Considering the Resolution of the Collegiate Board RDC 586 of 2013, which regulates the clinical actions of the pharmacist, among them the prescription of laboratory tests to monitor the pharmacotherapy, the study aims to evaluate the impact of the request for vancomycin serum concentration by the pharmacist in a university hospital compared to other professionals. Methods: Patients who used vancomycin within a four-month period were included, being divided into group A, with patients who underwent the examination having the exclusive prescription by the assistant medical team between July and August 2021, and in group B with the examination prescribed by the pharmacist, between September and October 2021, patient demographic data, laboratory results of creatinine and dosage of vancomycin, number of vancomycin dosages collected, etiology of infections, culture results, and de-escalation of therapy were collected. Results: 22 patients were included for group A and 23 for group B. The results of initial and final creatinine, creatinine change, nephrotoxicity and vancomycin trough result in the therapeutic target did not show statistical differences between the groups. The total number of collections and the number of collections until reaching the therapeutic target of each patient differed between the groups, being higher in both for group B (p=0.01), requested by the pharmacist. In addition, the number of patients who reached the therapeutic target was 16 (69.56%) for group B against 6 (27.27%) for group A (p=0.01). Conclusion: The findings suggested pharmaceutical action in the follow-up of vancokinemia, as well as the direct prescription of the plasma dosage test of this antimicrobial by this professional, can contribute to greater therapeutic success and obtaining the optimized dosage for the individuality of each patient.