Therapeutic drug monitoring in a community hospital

This study describes an aminoglycoside dosing service in a community hospital. Between 95 and 98% of all aminoglycoside doses are calculated by staff pharmacists using traditional pharmacokinetic equations. All patients dosed by the pharmacy are then monitored by clinical pharmacists who make necessary dosage modifications following serum peak and trough levels. After the first year of this service, it was determined that a slight change in the volume of distribution equation would allow the pharmacy to calculate maintenance doses that would more accurately result in estimated serum peak and trough levels. Physicians are pleased with this service and professional job satisfaction is experienced by the pharmacists. Therapeutic drug monitoring is an important component of patient care and can be implemented in community hospitals. Other pharmacy departments are encouraged to establish similar services.