Rogers Matthew S, Cullen Mairi M, Boxall Emma M, Chadwick Paul R
Department of Microbiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry & Warwickshire Hospital, Stoney Stanton Road, Coventry CV1 4FH, UK.
J Antimicrob Chemother. 2005 Sep;56(3):566-8. doi: 10.1093/jac/dki279. Epub 2005 Aug 2.
Compliance with our local hospital policy for gentamicin administration and monitoring was found to be inadequate on audit. A gentamicin monitoring form was introduced with the aim of improving staff compliance with the policy thus minimizing the risks of toxicity while ensuring adequate dosing.
The initial audit examined the prescribing, administration and monitoring of intravenous gentamicin given to 20 patients. The introduction of a gentamicin monitoring form was prompted by unsatisfactory initial dosing and subsequent monitoring and adjustment of gentamicin doses.
Following introduction of the monitoring form, the proportion of appropriate starting doses had increased from 13 out of 20 to 18 out of 20 prescriptions. The timing of initial serum levels was significantly better: 18 timed correctly, compared with 12 in initial audit. Subsequent administration and monitoring appeared more compliant with fewer doses inappropriately omitted and more levels checked appropriately. No improvement was seen in the quality of dose adjustment.
In conjunction with the support and advice of the pharmacy and microbiology departments, the use of a gentamicin monitoring form can improve the quality of intravenous gentamicin use in the hospital setting.
审核发现，我院当地关于庆大霉素给药及监测的政策依从性不足。为此引入了一份庆大霉素监测表，旨在提高医护人员对该政策的依从性，从而在确保给药剂量充足的同时，将毒性风险降至最低。
初次审核检查了给予20例患者的静脉注射庆大霉素的处方、给药及监测情况。由于初次给药剂量及随后的庆大霉素剂量监测与调整不尽人意，故而引入了庆大霉素监测表。
引入监测表后，合适起始剂量的处方比例从20例中的13例增至20例中的18例。首次血清检测的时间安排明显改善：18次检测时间正确，而初次审核时为12次。后续给药及监测似乎更符合要求，遗漏的不当剂量减少，适当检查的水平增多。剂量调整质量未见改善。
在药学和微生物学部门的支持与建议下，使用庆大霉素监测表可提高医院环境中静脉注射庆大霉素的使用质量。
