Ritchie D J, Reichley R M, Canaday K L, Bailey T C
St. Louis College of Pharmacy, MO 63110.
J Pharm Technol. 1993 Jul-Aug;9(4):160-3.
To evaluate the financial impact of adjusting imipenem/cilastatin (IC) dosages in elderly patients based on estimated creatinine clearance (Cl cr) and body weight.
Retrospective cost-savings analysis.
A 500-bed, university-affiliated, tertiary-care hospital.
All courses of IC administered to patients over age 60 during a four-month period were retrospectively assessed for appropriateness based on both dosing interval and dosage. Manufacturer's guidelines for adjusting the IC dosage based on estimated CL cr and body weight were used to define appropriate dosing. The cost savings that could have been realized by appropriately adjusting IC dosage was calculated for the study period and extrapolated to project an annual cost savings.
Only 37 percent of patient days of therapy and 32 percent of therapy courses were judged as appropriate based on both dose amount and interval. The projected annual cost savings that could have been realized by appropriately adjusting IC dosage based on estimated Cl cr and body weight was $11,500.
Adjustment of IC dosages in elderly patients based on estimated Cl cr and body weight can result in significant cost savings.
基于估计的肌酐清除率（Cl cr）和体重评估调整老年患者亚胺培南/西司他丁（IC）剂量的财务影响。
回顾性成本节约分析。
一家拥有500张床位的大学附属医院，三级护理医院。
回顾性评估在四个月期间给予60岁以上患者的所有IC疗程在给药间隔和剂量方面的适宜性。根据基于估计的Cl cr和体重调整IC剂量的制造商指南来定义适宜剂量。计算在研究期间通过适当调整IC剂量本可实现的成本节约，并外推以预测年度成本节约。
基于剂量和间隔判断，仅37%的患者治疗日和32%的治疗疗程被判定为适宜。根据估计的Cl cr和体重适当调整IC剂量本可实现的预计年度成本节约为11,500美元。
基于估计的Cl cr和体重调整老年患者的IC剂量可显著节约成本。
