A multicenter audit of 1295 daptomycin prescriptions in the Auvergne-Rhône-Alpes region.

Abstract

Objective: We conducted an audit of daptomycin prescriptions for patients hospitalized in the Auvergne-Rhône-Alpes region. The audit was performed in the scope of contracts designed to improve the quality and efficiency of patient care between hospitals and the regional health agency.

Patients and method: This retrospective multicenter study was conducted using the clinical audit method on data collected in 2023. The local referent healthcare professional assessed prescription appropriateness with regard to guidelines, based on data available in computerized medical records.

Results: All in all, 1295 daptomycin prescriptions from 50 hospitals were included. Median patient age was 72 years (61-80). A majority of prescriptions were initiated for bone and joint infections (n = 573, 44.2 %), most often in orthopedic wards (n = 445, 34.4 %). Bacteriological documentation was obtained in 40.5 % (n = 524) of cases. The prescription was considered appropriate in 87.1 % (n = 1128). A total of 132 inappropriate prescriptions for 120 patients were identified: 33.3 % (n = 44) were inappropriate indications, 25 % (n = 33) were due to a lack of de-escalation following microbiological documentation, 16.7 % (n = 22) involved inappropriate dosing and 15.9 % (n = 21) concerned inappropriate treatment duration. Written recommendations for treatment of an infectious disease recommendation were found for 38.8 % (n = 503) of prescriptions; they were associated with higher appropriateness (386/410 (94.1 %) vs. 65/93 (69.9 %), p < 0.00001).

Conclusion: This study found that while appropriateness of daptomycin prescriptions in Auvergne-Rhône-Alpes was generally satisfactory, it was limited by the self-evaluation method applied. In addition, areas for with potential for improvement in daptomycin prescription were identified.