Evaluation of an imipenem/cilastatin target drug program

DICP. 1991 Apr;25(4):348-50. doi: 10.1177/106002809102500402.

Abstract

This article describes an imipenem/cilastatin (I/C) target drug program. The program, developed following completion of a drug usage evaluation study, was designed to improve I/C dosing, reduce central nervous system (CNS) adverse effects, and reduce antibiotic costs. Following completion of an inservice education program for the medical and pharmacy professional staffs, ongoing monitoring of I/C usage was accomplished through the pharmacy-based drug-dosing service. Pharmacists evaluated I/C dosage based upon culture/sensitivity results and indicators of renal function. If deemed inappropriate, the pharmacist contacted the prescribing physician with a dosage recommendation. Two hundred ten courses of I/C therapy were prescribed in the nine-month period following implementation of the target drug program; 26 cases (12 percent) required dosage adjustment. The incidence of CNS adverse effects including seizures decreased from 15 to 1 percent (p = 0.0015). A $6033 drug cost avoidance also resulted from pharmacist intervention.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteria, Anaerobic / drug effects
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / microbiology
  • Central Nervous System Diseases / chemically induced
  • Cilastatin / adverse effects
  • Cilastatin / therapeutic use*
  • Cilastatin, Imipenem Drug Combination
  • Cost Savings
  • Drug Combinations
  • Drug Costs
  • Drug Monitoring / economics*
  • Gram-Negative Bacteria / drug effects
  • Gram-Positive Bacteria / drug effects
  • Humans
  • Imipenem / adverse effects
  • Imipenem / therapeutic use*
  • Kidney Diseases / chemically induced
  • Pharmacy Service, Hospital*

Substances

  • Anti-Bacterial Agents
  • Drug Combinations
  • Cilastatin
  • Imipenem
  • Cilastatin, Imipenem Drug Combination