Tygacil

[spacecowgirl]

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What do you think about it? Is there a need for it? Is the cost justified? I calculated a 14 days treatment to be over $15,000 AWP.

 

[ZpackSux]

What do you think about it? Is there a need for it? Is the cost justified? I calculated a 14 days treatment to be over $15,000 AWP.

http://forums.studentdoctor.net/showthread.php?t=204278


You tell me. Is it worth it? It has a fair gram positive aerobic and anaerobic coverage. Covers MRSA and indicated for intrabdominal infection.

Similar coverage compared to Vanco for MRSA.. and simlar compared to Imipenem in anaerobic coverage. So what distict advantage does it provide over existing abx? Is it cost effective? NO. I'm puttin together a game plan to make sure this drug is not added to our formulary. I don't see it being used in inpatient care setting.

 

[spacecowgirl]

Sorry, I should have searched first but since it quickly degenerated into a thread about Vanilla Ice, I guess I didn't miss too much 🙄

Still formulating my opinions but based on what I've read, I don't see what's so amazing about it except the very amazing price tag. If it does gain FDA approval for VRE, then maybe (correct me if I'm wrong but I was under the impression that clinical data suggests VRE is susceptible to it but it hasn't been approved for it yet). We know doctors don't always like to practice conservative and responsible prescribing with antibiotics though so we may need it sooner rather than later. 🙁

 

[ZpackSux]

Sorry, I should have searched first but since it quickly degenerated into a thread about Vanilla Ice, I guess I didn't miss too much 🙄

Still formulating my opinions but based on what I've read, I don't see what's so amazing about it except the very amazing price tag. If it does gain FDA approval for VRE, then maybe (correct me if I'm wrong but I was under the impression that clinical data suggests VRE is susceptible to it but it hasn't been approved for it yet). We know doctors don't always like to practice conservative and responsible prescribing with antibiotics though so we may need it sooner rather than later. 🙁

We have other tx option for VRE

 

[spacecowgirl]

We have other tx option for VRE

Not many from what I could find though.

But damn $15K! Just take me out back and shoot me instead

I was reading some creepy stuff about VRE transferring its vanc resistant properties to MRSA

 

[ZpackSux]

It's actually $43.63 per 50mg vial our cost. AWP is about $56 per 50mg

Initial dose of 100mg = $87.26

Then 27 doses of 50mg @ 43.63 = $1178.01

So, for 14 day treatment = $1265.27 absolute cost.

Not too bad.

 

[spacecowgirl]

Hmmm, the tech that found me that price told me that was a per vial price. It must have been for 10 instead, which sounds much more like what you said. I'll have to ask her again, because she was obviously wrong, there's just no way! That price is not much more than Zyvox.

 

[ZpackSux]

Hmmm, the tech that found me that price told me that was a per vial price. It must have been for 10 instead, which sounds much more like what you said. I'll have to ask her again, because she was obviously wrong, there's just no way! That price is not much more than Zyvox.

That's correct.

But Zyvox is still considered one of the most expensive antibiotics we carry..
Antifungal treatment is whole another story.

 

[WVUPharm2007]

So it's basically a tetracycline that binds with greater affinity to the 30S ribosomal unit than minocycline?


....right?

I say throw it in the cabinet next to Zyvox (you know, the cabinet with dust on the top where people hide their stash of Hershey Kisses from the other people in the pharmacy because nobody ever goes in there? THAT cabinet.), only use it when the patient has no other hope and quarantine them like the monkey in outbreak. Probably only needed once or twice a year where I'm at.

 

[ZpackSux]

So it's basically a tetracycline that binds with greater affinity to the 30S ribosomal unit than minocycline?


....right?

I say throw it in the cabinet next to Zyvox (you know, the cabinet with dust on the top where people hide their stash of Hershey Kisses from the other people in the pharmacy because nobody ever goes in there? THAT cabinet.), only use it when the patient has no other hope and quarantine them like the monkey in outbreak. Probably only needed once or twice a year where I'm at.

No, because it counts toward my inventory. Not a good business practice to keep something that you'll only use twice a year. That's why we let teaching hospitals in town to keep them. Then we send out a hot shot delivery to pick it up. The moment medical staff finds out we have a new drug in stock, they salivate and write for it.

 

[spacecowgirl]

The moment medical staff finds out we have a new drug in stock, they salivate and write for it.

Isn't that the truth. Since we started stocking Cymbalta you'd think no other antidepressant had ever existed!

As I suspected the tech did give me the cost of 10 vials. Guess I should have just looked it up myself in the first place 🙄 Oh well! Given that, it is comparable in price to Zyvox.

There's a super secret Hershey Kisses stash? I'm just here on rotation so I haven't figured these things out yet...

 

[aaron31981]

So it's basically a tetracycline that binds with greater affinity to the 30S ribosomal unit than minocycline?


....right?

I say throw it in the cabinet next to Zyvox (you know, the cabinet with dust on the top where people hide their stash of Hershey Kisses from the other people in the pharmacy because nobody ever goes in there? THAT cabinet.), only use it when the patient has no other hope and quarantine them like the monkey in outbreak. Probably only needed once or twice a year where I'm at.

It isn't effluxed out of the cell like other tetracyclines. Hence it has activity where others do not. Of course this is just based on the lectures I had ~ 6 weeks ago, so I assume they have found some efflux pump resistance by now 🙁