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Multidisciplinary protocol for determining aminoglycoside dosage.

T J Lynch1, C J Possidente, W G Cioffi

  • 1Department of Pharmacy, Medical Center Hospital of Vermont, Burlington 05401.

American Journal of Hospital Pharmacy
|January 1, 1992
PubMed
Summary
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This study introduces an aminoglycoside dosing protocol for surgical patients, improving therapeutic drug levels within 48 hours. The collaborative approach enhanced safety and efficiency in managing aminoglycoside therapy.

Area of Science:

  • Pharmacology
  • Clinical Pharmacy
  • Infectious Disease Management

Background:

  • Aminoglycoside antibiotics require careful dosing to balance efficacy and toxicity.
  • Optimizing early-stage aminoglycoside therapy is crucial for surgical patients.
  • Existing dosing methods may lack consistency and efficiency.

Purpose of the Study:

  • To describe and evaluate a collaborative protocol for optimizing aminoglycoside dosing in surgical patients.
  • To assess the protocol's impact on achieving therapeutic and nontoxic drug concentrations.
  • To determine the protocol's effect on drug monitoring efficiency and patient safety.

Main Methods:

  • Development of a multidisciplinary aminoglycoside dosing protocol involving physicians, nurses, and pharmacists.

Related Experiment Videos

  • Utilization of a nomogram for initial dose calculation and an antimicrobial order form.
  • Implementation of standardized procedures for drug administration, blood sampling, and serum concentration monitoring.
  • Retrospective review of surgical patient records before and after protocol implementation.
  • Main Results:

    • A higher percentage of patients achieved therapeutic, nontoxic aminoglycoside dosages within 48 hours under the protocol.
    • Reduced number of serum drug concentration tests per patient, with a higher percentage of useful results.
    • No significant change in the mean duration of aminoglycoside therapy.
    • A trend towards fewer nephrotoxic reactions in patients managed with the protocol.

    Conclusions:

    • The collaborative aminoglycoside dosing protocol ensures consistent, safe, and effective management of aminoglycoside therapy.
    • Multidisciplinary cooperation is key to optimizing antibiotic dosing and patient outcomes.
    • The protocol improves therapeutic drug monitoring efficiency and potentially reduces adverse events.