Abstract Introduction The aim of this study was to determine whether the implementation of new educational interventions could reduce the use of teicoplanin in Diabetic Foot Infections (DFI) on a Vascular surgical firm and prevent potential toxicity. Local trust guidelines state that DFI should be treated with piperacillin-tazobactam and teicoplanin. Following a groin/nasal swab, teicoplanin can then be withdrawn if the patient has a negative screen for MRSA (methicillin-resistant Staphylococcus aureus). Methods Interventions were undertaken to reduce overuse of teicoplanin. These consisted of Ward Pharmacist teaching, updating the Vascular Doctor Handbook and sending an email to the Ward Juniors explaining current antibiotic guidelines. Alongside these interventions was the pre-existing weekly microbiology Consultant-led ward rounds. Teicoplanin prescribing was compared in patient groups identified pre (n=44) and post intervention (n=36). Inclusion criteria were diabetes/ prediabetes, no allergies to penicillin or teicoplanin and no prosthetic material grafts in situ. Results The mean number of excess doses of teicoplanin decreased from 4.84 (pre-intervention) to 1.00 (post-intervention). Largest excess doses received by one patient was reduced from 11 to 6. One 400 mg teicoplanin vial costs £9.30, resulting in an average saving of £35.71 per patient. Conclusion The described interventions reduced the number of excess teicoplanin doses for DFI on the Vascular firm. This resulted in a more cost-effective practice, drug administration rounds becoming more time efficient and resulting in less waste thus facilitating more sustainable practice. Future research could further explore the impact on sustainability by calculating carbon emissions of antibiotic usage on the ward. Take-home message Educational interventions have helped reduce excess use of teicoplanin in Diabetic Foot Infections for patients under the care of a vascular surgical firm. This has led to a reduction in time and expenses, thus promoting a more sustainable practice.
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