ĐÁNH GIÁ HIỆU QUẢ CAN THIỆP CỦA DƯỢC LÂM SÀNG TRÊN VIỆC GIÁM SÁT NỒNG ĐỘ ĐIỀU TRỊ VANCOMYCIN TẠI BỆNH VIỆN HOÀN MỸ SÀI GÒN NĂM 2023-2025

Abstract

Background: Clinical pharmacy interventions in therapeutic drug monitoring (TDM) of vancomycin play an important role in optimizing treatment efficacy. Since early 2024, Hoan My Sai Gon Hospital has implemented clinical pharmacy interventions to improve TDM practices for vancomycin. Objective: To evaluate the effectiveness of clinical pharmacy interventions in vancomycin TDM. Methods: A retrospective study was conducted on 214 inpatient medical records involving vancomycin use, divided into two phases: pre-intervention (01/01/2023–31/12/2023) and post-intervention (01/03/2024–28/02/2025), with 107 records in each group. Results: The baseline characteristics between the two groups were similar: median age was comparable, over 67% of patients were aged ≥60, more than 50% were overweight/obese, and 50% had normal eGFR. Statistically significant differences were observed in Charlson score and laboratory parameters including white blood cell count, platelet count, CRP, and PCT (p < 0.05). Clinical pharmacy interventions increased the rate of TDM implementation from 35.7% to 65.2% (p < 0.0001) and improved the appropriateness of TDM indication from 48.6% to 82.9% (p < 0.0001). However, no significant difference was observed in the proportion of patients achieving target AUC/MIC values (p > 0.05). Conclusion: Clinical pharmacy interventions significantly improved TDM implementation and appropriateness of TDM indications for vancomycin, though they did not markedly increase the rate of achieving target AUC/MIC.