Brown G
St. Paul's Hospital, Vancouver, British Columbia, Canada.
Hosp Pharm. 1995 Jan;30(1):33-6.
The development of aminoglycoside toxicity has been reported related to duration of exposure. To potentially reduce the duration of exposure to aminoglycosides, pharmacists documented, via a permanent note in the patient health record, the exposure and potential associated risks of any patient who received greater than 10 consecutive days or 20 days total within 3 months of aminoglycoside therapy at this institution. The impact of the notification on further aminoglycoside exposure was evaluated over two 6-month periods. Notification was successful in ending further aminoglycoside exposure in 25 of 57 patients. Continued aminoglycoside therapy primarily involved treatment of febrile neutropenia and endocarditis. Prevention of toxicity was suggested in the second evaluation period in which none of the patients, having therapy altered by the notification, developed toxicity versus 13 of the 40 other patients who developed a rise in serum creatinine concentration or a reduction in hearing acuity. The methodology that produced these positive results should be easily transferable to other institutions.
据报道，氨基糖苷类药物毒性的发生与暴露时间有关。为了潜在地缩短氨基糖苷类药物的暴露时间，药师通过在患者健康记录中永久记录，记录了在本机构接受氨基糖苷类治疗3个月内连续使用超过10天或总计使用20天的任何患者的暴露情况及潜在相关风险。在两个6个月期间评估了该通知对进一步氨基糖苷类药物暴露的影响。通知成功终止了57例患者中25例的进一步氨基糖苷类药物暴露。继续使用氨基糖苷类药物治疗主要涉及发热性中性粒细胞减少症和心内膜炎的治疗。在第二个评估期提示预防了毒性，在该评估期，因通知而改变治疗的患者中无一人发生毒性，而其他40例患者中有13例出现血清肌酐浓度升高或听力减退。产生这些积极结果的方法应易于推广至其他机构。
