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Clinical and economic impact of a pharmacist‐intervention to promote sequential intravenous to oral clindamycin conversion

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Abstract

A multicentre, prospective, controlled study compared the clinical efficacy, safety and economic impact of a pharmacist intervention to promote sequential intravenous to oral clindamycin conversion. A total of 473 patients receiving intravenous clindamycin for at least 72 hours were included in the study. Two groups were established: an intervention group (204 patients) in which an informative sheet recommending the sequential treatment was provided, and a control group (269 patients). Clindamycin was prescribed for respiratory infections in 38.9% and for prophylaxis in surgery in 25.4% of the patients (71% were contaminated surgery). No difference between groups regarding sex, infection severity, health status or clinical progress was observed. Both the step‐down treatments after 72 hours of intravenous clindamycin and the change to the oral route later on, were significantly increased with the intervention (p<0.001, p<0.001 respectively). No significant differences between both groups were found in the number of patients with adverse effects associated with the IV therapy, although the incidence tended to be lower in the intervention group (49/204 intervention versus 85/269 control, p=0.07). Compliance with the recommended clindamycin dosing regimen was significantly higher in the intervention group, in which 1.3 days reduction of intravenous therapy provided an average cost savings of PTA5246 (95%CI 2556‐7935) per treatment. A higher reduction of 1.7 days was achieved in those patients candidates for switch therapy on the third day of intravenous clindamycin. A sequential program with clindamycin may provide a cost‐effective alternative to conventional therapy and the introduction of an information sheet is a cost‐effective strategy to promote it.

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Authors and Affiliations

  1. Department of Pharmacy, Meixoeiro Hospital, Meixoeiro s/n, 36200, Vigo. Pontevedra, Spain

    María J. Martínez

  2. Department of Pharmacy, Arquitecto Marcide Hospital, Ctra. de San Pedro s/n, 15405, Ferrol. La Coruña, Spain

    Angeles Freire, Isaura Rodriguez & Belén Bardán

  3. Department of Pharmacy, Meixoeiro Hospital, Meixoeiro s/n, Pontevedra, Spain

    Inés Castro & María T. Inaraja

  4. Clínica Universitaria de Navarra, Avda, Pamplona, Navarra, Spain

    Ana Ortega

  5. Department of Epidemiology, Meixoeiro Hospital. Meixoeiro s/n, 36200, Vigo. Pontevedra, Spain

    Victor Del Campo

  6. Department of Internal Medicine‐Infectious Diseases, Meixoeiro Hospital, Vigo. Pontevedra, Spain

    Luis E. Morano

  7. Department of Internal Medicine‐Infectious Diseases, Arquitecto Marcide Hospital, La Coruña, Spain

    José F. Garcia

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  1. María J. Martínez
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Martínez, M.J., Freire, A., Rodriguez, I. et al. Clinical and economic impact of a pharmacist‐intervention to promote sequential intravenous to oral clindamycin conversion. Pharm World Sci 22, 53–58 (2000). https://doi.org/10.1023/A:1008769204178

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