Does accepting pharmacokinetic recommendations impact hospitalization? A cost-benefit analysis

Area of Science:

• Pharmacology
• Clinical Pharmacy
• Health Economics

Background:

• Aminoglycosides are critical antibiotics but require careful dosing to maximize efficacy and minimize toxicity.
• Clinical pharmacokinetic services (CPS) aim to optimize drug dosing through individualized monitoring.
• The impact of full adherence to CPS recommendations on clinical outcomes and costs requires further investigation.

Purpose of the Study:

• To evaluate the clinical and economic impact of 100% adherence to clinical pharmacokinetic service (CPS) recommendations for aminoglycoside therapy.
• To compare hospitalization duration, febrile periods, and direct costs between patients with full and partial adherence to CPS recommendations.

Main Methods:

• Prospective, randomized study involving 110 adult patients receiving aminoglycosides.
• Patients were randomized to follow-up by a CPS.
• Data collected included hospitalization duration, febrile periods, and direct hospitalization costs.
• Cost-benefit analysis was performed using a cost-to-charge ratio.

Main Results:

• Patients with 100% adherence to CPS recommendations had significantly shorter hospitalizations (322.67 h vs. 699.54 h; p = 0.001) and febrile periods (50.05 h vs. 120.00 h; p = 0.002).
• Full adherence also led to substantially lower direct hospitalization costs ($7,102.56 vs. $19,629.94; p < 0.001).
• The direct cost of the CPS was calculated at $85 per patient.

Conclusions:

• Complete acceptance of CPS recommendations for aminoglycoside therapy improves clinical outcomes, including reduced length of stay and fever duration.
• Implementing CPS for aminoglycoside management is highly cost-effective, demonstrating significant savings in direct hospitalization costs.
• Pharmacist-led pharmacokinetic monitoring and recommendation adherence are crucial for optimizing patient care and resource utilization.