Aminoglycoside dosing service provided by baccalaureate-level pharmacists

An aminoglycoside pharmacokinetic dosing service operated primarily by baccalaureate-level pharmacists is described. The service was initiated gradually by the clinical pharmacy coordinator. After detailed policies and procedures were developed, staff pharmacists received 14 hours of training in pharmacokinetics. The training program consisted of written study material and application to actual patient cases. The pharmacokinetic dosing service is initiated upon the written request of a physician. Nurses on the pharmacy i.v. team administer aminoglycoside doses, collect blood samples, and record sample collection and drug infusion times whenever possible; when workload is heavy, floor nurses and laboratory personnel assist in these functions. The entire dosing consult requires approximately one hour of pharmacist time per patient. A $20 fee is assessed for completed dosing consults. Approximately 50 consults are provided per months, and a survey showed that 50-70% of all hospital patients (except newborns in intensive care) receiving aminoglycosides had their dosages calculated by the service. A carefully developed limited aminoglycoside dosing service provided primarily by baccalaureate-level pharmacists has given the pharmacy department at this hospital an opportunity to further expand its involvement in clinical pharmacokinetics.