ĐÁNH GIÁ CHI PHÍ – HIỆU QUẢ CỦA VANCOMYCIN TRƯỚC VÀ SAU KHI ÁP DỤNG KỸ THUẬT THEO DÕI NỒNG ĐỘ THUỐC TRONG MÁU BẰNG THÔNG SỐ AUC MỤC TIÊU TẠI BỆNH VIỆN BỆNH NHIỆT ĐỚI THÀNH PHỐ HỒ CHÍ MINH GIAI ĐOẠN 2020-2021

Abstract

Introduction: Therapeutic Drug Monitoring (TDM) is one recommendation for vancomycin dosing optimization. This study was conducted to evaluate the cost-effectiveness of vancomycin TDM before and after applying the target AUC approach at the Hospital For Tropical Diseases. Materials and Methodology: A cross-sectional, retrospective study was conducted using data of patients using vancomycin in two periods (TDM C_trough (January 1, 2020 - June 30, 2020) and TDM AUC (January 1, 2021 – June 30, 2021)) at the Hospital for Tropical Diseases. Data collection includes demographic characteristics, characteristics of vancomycin use, costs and treatment outcomes according to treatment course of patients indicated with vancomycin. Results and Discussions: The TDM AUC process was more cost-effective than the TDM C_trough phase in terms of criteria: improved clinical response at the time point of 24 - 48 hours, 48 - 72 hours and at the end of vancomycin course and reducing risks of nephrotoxicity. However, TDM C_trough achieved the cost-effectiveness against TDM AUC pertaining to reducing the length of vancomycin therapy with the ICER equals to 2.394.519 VND. Conclusion: The implementation process of vancomycin AUC monitoring needs to be continued at the hospital. Besides, it is necessary to adjust and build a pharmacokinetic model suitable for the patient population at the hospital as well as the Vietnamese population.