A utilization and cost-benefit analysis of an aminoglycoside kinetics monitoring service

Utilization and cost-benefit analysis of an aminoglycoside kinetics monitoring service were performed. Utilization was reviewed for 161 patients using the service between May 1, 1986 and April 30, 1987. The cost-benefit analysis used a cohort of 48 matched patients for the same time period. Pharmacy-based dosing recommendations were compared to physician-based dosing recommendations. According to specific guidelines, most pharmacy-based dosing recommendations were acceptable (91%) and followed either in full (76%) or in part (13.6%). According to specified criteria, gentamicin could have been substituted for tobramycin in 29.4% of courses of therapy. No statistically significant benefits (p less than 0.05) were associated with pharmacy-based recommendations, which cost $47.43 each, or $26.48 more than a physician-based recommendation. Although the service yields appropriate recommendations and is well received, our results suggest that further studies must be conducted to define methods by which a cost-benefit ratio greater than one may be realized.