title: A controlled trial of the cost benefit of computerized bayesian aminoglycoside administration.
abstract: We studied the effect of a bayesian pharmacokinetic dosing program on the outcome of aminoglycoside therapy in patients with clinical infections. Patients were randomized to a control (dosing based on physician choice; n = 75) or experimental group (dosing based on the bayesian program; n = 72). Both groups used serum aminoglycoside concentration data when making dosing decisions. Improved response rates were seen in the experimental (60%; 42/68) compared with the control group (48%; 36/68). A higher, but not statistically significant, incidence of toxicity was found in the control (7/75; 9.7%) versus the experimental group (4/72; 5.1%). Mean length of total hospital stay was significantly longer for patients in the control group (20.3 days) compared with the experimental group (16.0 days) (p = 0.028). The variables from multivariate analysis with a significant impact on length of stay were patient group and length of aminoglycoside therapy. On the basis of a reduced length of stay, a potential cost savings of $1311 per patient can be achieved.
authors.affiliation: Clinical Pharmacology Section, Department of Veterans Affairs Medical Center, Dallas.
authors.forename: M E
authors.initials: ME
authors.lastname: Burton
authors.forename: C L
authors.initials: CL
authors.lastname: Ash
authors.forename: D P
authors.initials: DP
authors.lastname: Hill
authors.forename: T
authors.initials: T
authors.lastname: Handy
authors.forename: M D
authors.initials: MD
authors.lastname: Shepherd
authors.forename: M R
authors.initials: MR
authors.lastname: Vasko
mesh_terms: D000617:Aminoglycosides / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D001499:Bayes Theorem; D003201:Computers; D003362:Cost-Benefit Analysis; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D012044:Regression Analysis
chemical_list: D000617:Aminoglycosides