Pharmacoeconomic impact of once-daily aminoglycoside administration.
A retrospective cost analysis compared hospital costs of standard gentamicin dosing and once-daily regimens in 1127 patients. Hospital costs compared were drug/supply/preparation/administration (DSPA; $4.56/500 mg once-daily dose and $3.32/100 mg every 8 hrs standard dose); therapeutic drug monitoring (TDM) ($25/gentamicin level); and nephrotoxicity management. The mean length of therapy was 4.5 days with both regimens. The mean number of blood samples drawn to measure drug levels was 0.65 for once-daily dosing and 1.7 for standard dosing. Mean DSPA and TDM costs/patient for a 4.5-day course of once-daily therapy were $20.52 and $16.25, respectively ($36.77/course of therapy). In comparison, estimated mean DSPA and TDM costs for 4.5 days standard therapy were $44.82 and $42.50, respectively ($87.32/course of therapy). We observed an overall reduction in nephrotoxicity from approximately 4% to 1.2% with the once-daily program, resulting in a nephrotoxicity management cost reduction from $182 to $55/patient exposed to aminoglycosides. The once-daily program resulted in a 58% reduction in aminoglycoside-associated hospital cost and a nephrotoxicity management savings of 70%/patient.
Hitt
C M
CM
Hospital Pharmacy Services, Mayo Medical Center, Rochester, Minnesota 55902, USA.
Klepser
M E
ME
Nightingale
C H
CH
Quintiliani
R
R
Nicolau
D P
DP
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics*; D003365:Costs and Cost Analysis; D004469:Economics, Hospital; D005839:Gentamicins / Q000008:administration & dosage / Q000191:economics*; D006761:Hospitals; D006801:Humans; D007674:Kidney Diseases / Q000191:economics / Q000517:prevention & control; D008910:Minnesota; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents; D005839:Gentamicins