title: Individualized pharmacokinetic monitoring results in less aminoglycoside-associated nephrotoxicity and fewer associated costs.
abstract: OBJECTIVE
  To examine the impact of individualized pharmacokinetic monitoring (IPM) on the development of aminoglycoside-associated nephrotoxicity (AAN).
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  Two teaching hospitals.
  
  
  METHODS
  Two thousand four hundred five patients who received aminoglycosides.
  
  
  METHODS
  Aminoglycoside therapy dosed by either IPM or physicians' directions.
  
  
  RESULTS
  Patients receiving IPM were significantly less likely to develop AAN by both univariate (7.9% vs 13.2%, p=0.02) and multivariate methods (odds ratio 0.42, p=0.002). Female sex was protective against AAN. Age 50 years and above, high initial aminoglycoside trough, long duration of therapy, and concurrent piperacillin, clindamycin, or vancomycin increased risk of AAN. We estimated that IPM decreased AAN costs by $90,995/100 patients.
  
  
  CONCLUSIONS
  Individualized pharmacokinetic monitoring significantly decreased the frequency of AAN and its associated economic costs.
authors: Clinical Pharmacology Research Center, Bassett Healthcare, Cooperstown, New York, USA.
authors: D S
authors: DS
authors: Streetman
authors: A N
authors: AN
authors: Nafziger
authors: C J
authors: CJ
authors: Destache
authors: A S
authors: AS
authors: Bertino
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000191:economics / Q000493:pharmacokinetics; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood*; D017850:Economics, Pharmaceutical; D005260:Female; D005839:Gentamicins / Q000009:adverse effects / Q000191:economics / Q000493:pharmacokinetics; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014031:Tobramycin / Q000009:adverse effects / Q000191:economics / Q000493:pharmacokinetics
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D003404:Creatinine; D014031:Tobramycin