Impact of a clinical pharmacokinetic service on patients treated with aminoglycosides: a cost-benefit analysis.
In a prospective, randomized study, 75 adults receiving aminoglycosides were followed by a clinical pharmacokinetic service and 70 followed as controls. The two groups were similar in age, gender, height, and APACHE II score. A cost-to-charge ratio was used to derive direct costs of hospitalization and calculate cost-benefit. Excluded from this comparison were patients with incomplete acceptance of pharmacokinetic service recommendations and patients followed by other clinical pharmacists. Pharmacokinetic service patients had shorter hospitalizations (322.67 +/- 270.28 h; controls 442.89 +/- 536.81, p = 0.087) and febrile periods (50.05 +/- 79.38 h; controls 92.23 +/- 122.50, p less than 0.05). More pharmacokinetic service patients had adequate peak levels. Pharmacokinetic service direct costs were lower ($7,102.56 +/- 9,898.19; controls $13,758.64 +/- 22,874.31, p less than 0.05). Calculated direct cost of the service was $85.00/patient. Annual savings for 500 patients is $2,220,540.00.
Destache
C J
CJ
Clinical Pharmacokinetic Service, AMI Saint Joseph Hospital, Omaha, Nebraska 68131.
Meyer
S K
SK
Bittner
M J
MJ
Hermann
K G
KG
D000583:Amikacin / Q000097:blood*; D000617:Aminoglycosides / Q000097:blood; D001424:Bacterial Infections / Q000097:blood* / Q000188:drug therapy; D003362:Cost-Benefit Analysis; D005260:Female; D005839:Gentamicins / Q000097:blood*; D006090:Gram-Negative Bacteria; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008991:Monitoring, Physiologic / Q000191:economics*; D011446:Prospective Studies; D014031:Tobramycin / Q000097:blood*
D000617:Aminoglycosides; D005839:Gentamicins; D000583:Amikacin; D014031:Tobramycin