TY - JOUR
T1 - Individualized pharmacokinetic monitoring results in less aminoglycoside-associated nephrotoxicity and fewer associated costs
AU - Streetman, Daniel S.
AU - Nafziger, Anne N.
AU - Destache, Christopher J.
AU - Bertino, Joseph S.
PY - 2001/1/1
Y1 - 2001/1/1
N2 - Study Objective. To examine the impact of individualized pharmacokinetic monitoring (IPM) on the development of aminoglycoside-associated nephrotoxicity (AAN). Design. Retrospective case-control study. Setting. Two teaching hospitals. Subjects. Two thousand four hundred five patients who received aminoglycosides. Intervention. Aminoglycoside therapy dosed by either IPM or physicians' directions. Measurements and Main 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. Conclusion. Individualized pharmacokinetic monitoring significantly decreased the frequency of AAN and its associated economic costs.
AB - Study Objective. To examine the impact of individualized pharmacokinetic monitoring (IPM) on the development of aminoglycoside-associated nephrotoxicity (AAN). Design. Retrospective case-control study. Setting. Two teaching hospitals. Subjects. Two thousand four hundred five patients who received aminoglycosides. Intervention. Aminoglycoside therapy dosed by either IPM or physicians' directions. Measurements and Main 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. Conclusion. Individualized pharmacokinetic monitoring significantly decreased the frequency of AAN and its associated economic costs.
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U2 - 10.1592/phco.21.5.443.34490
DO - 10.1592/phco.21.5.443.34490
M3 - Article
C2 - 11310518
AN - SCOPUS:0035066593
VL - 21
SP - 443
EP - 451
JO - Pharmacotherapy
JF - Pharmacotherapy
SN - 0277-0008
IS - 4
ER -