Trends in teicoplanin loading dose implementation from 2010 to 2019 and evaluation of safety and efficacy factors: a retrospective cohort study based on a Japanese administrative claims database
Abstract Background The loading dose of teicoplanin (TEIC) is recommended for implementation. However, there is significant discrepancy between the dose settings in the package insert and, in the guidelines, and the actual status of loading doses in Japan is unclear. Furthermore, TEIC causes liver i...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | Journal of Pharmaceutical Health Care and Sciences |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40780-023-00304-y |
| _version_ | 1797557633087963136 |
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| author | Ryota Goto Yuichi Muraki Ryo Inose Moeno Ichii Keisuke Sawada Kanako Mizuno Ryuji Koizumi Shinya Tsuzuki Masahiro Ishikane Norio Ohmagari |
| author_facet | Ryota Goto Yuichi Muraki Ryo Inose Moeno Ichii Keisuke Sawada Kanako Mizuno Ryuji Koizumi Shinya Tsuzuki Masahiro Ishikane Norio Ohmagari |
| author_sort | Ryota Goto |
| collection | DOAJ |
| description | Abstract Background The loading dose of teicoplanin (TEIC) is recommended for implementation. However, there is significant discrepancy between the dose settings in the package insert and, in the guidelines, and the actual status of loading doses in Japan is unclear. Furthermore, TEIC causes liver injury as side effect. Although the risk of developing liver injury has not been reported to be increased following a loading dose based on the guidelines, there is a lack of reports in large populations. Therefore, we evaluated the trend in the loading dose and factors affecting the efficacy and safety of TEIC administration. Methods A Japanese administrative claims database was used in this study. Trends in loading doses were evaluated in target populations administered TEIC between 2010 and 2019. Patient characteristics were adjusted by propensity score matching based on the guideline group (total dose of 3 days > 1,600 mg) and non-guideline group (≤ 1,600 mg) of the loading dose. Finally, univariable and multivariable conditional logistic regression analysis was performed to evaluate factors affecting 30-day mortality and liver injury. Results A total of 10,030 patients were selected based on these criteria. The proportion of loading doses based on the recommended guidelines showed an increase over time, regardless of the implementation of therapeutic drug monitoring (TDM), but especially so in cases where TDM was implemented, the loading doses were administered in accordance with the recommendations of the guidelines. Conditional logistic regression analysis showed a relationship between drug management and guidance fees (odds ratio [OR]: 0.45, 95% confidence interval [CI]: 0.36‒0.55), a reimbursement indicating pharmacist intervention, and a reduction in 30-day mortality. In addition, loading doses based on the recommended guidelines had no influence on liver injury, and other factors were not significantly associated with increased incidence of liver injury. Conclusion Thus, this study implies the benefits of pharmacological management as indicated by drug management and guidance fee and supports the implementation of loading doses based on the guideline on TEIC administration. |
| first_indexed | 2024-03-10T17:19:22Z |
| format | Article |
| id | doaj.art-81c79adbedbc4048a7087646f127b6d8 |
| institution | Directory Open Access Journal |
| issn | 2055-0294 |
| language | English |
| last_indexed | 2024-03-10T17:19:22Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Pharmaceutical Health Care and Sciences |
| spelling | doaj.art-81c79adbedbc4048a7087646f127b6d82023-11-20T10:23:32ZengBMCJournal of Pharmaceutical Health Care and Sciences2055-02942023-11-01911810.1186/s40780-023-00304-yTrends in teicoplanin loading dose implementation from 2010 to 2019 and evaluation of safety and efficacy factors: a retrospective cohort study based on a Japanese administrative claims databaseRyota Goto0Yuichi Muraki1Ryo Inose2Moeno Ichii3Keisuke Sawada4Kanako Mizuno5Ryuji Koizumi6Shinya Tsuzuki7Masahiro Ishikane8Norio Ohmagari9Department of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical UniversityDepartment of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical UniversityDepartment of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical UniversityDepartment of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical UniversityDepartment of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical UniversityDepartment of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical UniversityAMR Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and MedicineAMR Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and MedicineAMR Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and MedicineAMR Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and MedicineAbstract Background The loading dose of teicoplanin (TEIC) is recommended for implementation. However, there is significant discrepancy between the dose settings in the package insert and, in the guidelines, and the actual status of loading doses in Japan is unclear. Furthermore, TEIC causes liver injury as side effect. Although the risk of developing liver injury has not been reported to be increased following a loading dose based on the guidelines, there is a lack of reports in large populations. Therefore, we evaluated the trend in the loading dose and factors affecting the efficacy and safety of TEIC administration. Methods A Japanese administrative claims database was used in this study. Trends in loading doses were evaluated in target populations administered TEIC between 2010 and 2019. Patient characteristics were adjusted by propensity score matching based on the guideline group (total dose of 3 days > 1,600 mg) and non-guideline group (≤ 1,600 mg) of the loading dose. Finally, univariable and multivariable conditional logistic regression analysis was performed to evaluate factors affecting 30-day mortality and liver injury. Results A total of 10,030 patients were selected based on these criteria. The proportion of loading doses based on the recommended guidelines showed an increase over time, regardless of the implementation of therapeutic drug monitoring (TDM), but especially so in cases where TDM was implemented, the loading doses were administered in accordance with the recommendations of the guidelines. Conditional logistic regression analysis showed a relationship between drug management and guidance fees (odds ratio [OR]: 0.45, 95% confidence interval [CI]: 0.36‒0.55), a reimbursement indicating pharmacist intervention, and a reduction in 30-day mortality. In addition, loading doses based on the recommended guidelines had no influence on liver injury, and other factors were not significantly associated with increased incidence of liver injury. Conclusion Thus, this study implies the benefits of pharmacological management as indicated by drug management and guidance fee and supports the implementation of loading doses based on the guideline on TEIC administration.https://doi.org/10.1186/s40780-023-00304-yTeicoplaninDatabaseLoading doseLiver injuryMortalityMethicillin-resistant Staphylococcus aureus |
| spellingShingle | Ryota Goto Yuichi Muraki Ryo Inose Moeno Ichii Keisuke Sawada Kanako Mizuno Ryuji Koizumi Shinya Tsuzuki Masahiro Ishikane Norio Ohmagari Trends in teicoplanin loading dose implementation from 2010 to 2019 and evaluation of safety and efficacy factors: a retrospective cohort study based on a Japanese administrative claims database Journal of Pharmaceutical Health Care and Sciences Teicoplanin Database Loading dose Liver injury Mortality Methicillin-resistant Staphylococcus aureus |
| title | Trends in teicoplanin loading dose implementation from 2010 to 2019 and evaluation of safety and efficacy factors: a retrospective cohort study based on a Japanese administrative claims database |
| title_full | Trends in teicoplanin loading dose implementation from 2010 to 2019 and evaluation of safety and efficacy factors: a retrospective cohort study based on a Japanese administrative claims database |
| title_fullStr | Trends in teicoplanin loading dose implementation from 2010 to 2019 and evaluation of safety and efficacy factors: a retrospective cohort study based on a Japanese administrative claims database |
| title_full_unstemmed | Trends in teicoplanin loading dose implementation from 2010 to 2019 and evaluation of safety and efficacy factors: a retrospective cohort study based on a Japanese administrative claims database |
| title_short | Trends in teicoplanin loading dose implementation from 2010 to 2019 and evaluation of safety and efficacy factors: a retrospective cohort study based on a Japanese administrative claims database |
| title_sort | trends in teicoplanin loading dose implementation from 2010 to 2019 and evaluation of safety and efficacy factors a retrospective cohort study based on a japanese administrative claims database |
| topic | Teicoplanin Database Loading dose Liver injury Mortality Methicillin-resistant Staphylococcus aureus |
| url | https://doi.org/10.1186/s40780-023-00304-y |
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