Vol.73 No.6 November 2025
Benefits of avoiding disposal of residual vancomycin following vancomycin treatment
1)Department of Pharmacy, Tokyo Metropolitan Tama-Hokubu Medical Center, 1-7-1 Aoba, Higashimurayama, Tokyo, Japan
2)Department of Hematology, Tokyo Metropolitan Tama-Hokubu Medical Center
3)Department of Medicinal Therapy Research, Meiji Pharmaceutical University
Abstract
Vancomycin (VCM) is a frequently used antimicrobial drug for the treatment of infectious diseases. Previous studies have reported on the usefulness of therapeutic drug monitoring (TDM) guided by pharmacokinetic/pharmacodynamic parameters to optimize VCM therapy. To the best of our knowledge, no previous studies have reported on the economic benefits of minimizing residual drug disposal of VCM following VCM treatment. At our institute, we implemented TDM for VCM and introduced a system designed to minimize residual drug disposal. We conducted this retrospective study to evaluate our application of TDM for VCM over the past decade using this system. We enrolled patients admitted to our hospital who underwent TDM for VCM between March 1, 2010, and July 31, 2021, had no prior history of use of VCM, and received a treatment regimen following which 250 mg of VCM was expected to remain to be disposed of. The patients (n=51) were classified into two groups: the LOSS group (n=16), in which vials of VCM remained unused and were subsequently disposed of, and the non-LOSS group (n=35), in which the treatment regimen was adjusted so as to prevent disposal. The efficacy and safety of the two administration methods were evaluated by calculating the area under the concentration time curves (AUC0-24) and the number of acute kidney injury (AKI) events. The AUC0-24 and number cases with AKI events were similar between the two groups (p=0.147, p=0.664). In the non-LOSS group simulations, residual VCM vial disposal was reduced by 25% per case. Recently, the supply of certain drugs has become unstable; therefore, reducing the disposal of residual VCM may be expected to contribute to improving the stability of VCM supply.
Key word
vancomycin, dosage regimen, medical economics, therapeutic drug monitoring
Received
October 30, 2024
Accepted
July 7, 2025
Jpn. J. Chemother. 73 (6): 580-587, 2025
