Burton M E, Ash C L, Hill D P, Handy T, Shepherd M D, Vasko M R
Clinical Pharmacology Section, Department of Veterans Affairs Medical Center, Dallas.
Clin Pharmacol Ther. 1991 Jun;49(6):685-94. doi: 10.1038/clpt.1991.86.
We studied the effect of a bayesian pharmacokinetic dosing program on the outcome of aminoglycoside therapy in patients with clinical infections. Patients were randomized to a control (dosing based on physician choice; n = 75) or experimental group (dosing based on the bayesian program; n = 72). Both groups used serum aminoglycoside concentration data when making dosing decisions. Improved response rates were seen in the experimental (60%; 42/68) compared with the control group (48%; 36/68). A higher, but not statistically significant, incidence of toxicity was found in the control (7/75; 9.7%) versus the experimental group (4/72; 5.1%). Mean length of total hospital stay was significantly longer for patients in the control group (20.3 days) compared with the experimental group (16.0 days) (p = 0.028). The variables from multivariate analysis with a significant impact on length of stay were patient group and length of aminoglycoside therapy. On the basis of a reduced length of stay, a potential cost savings of $1311 per patient can be achieved.
我们研究了贝叶斯药代动力学给药方案对临床感染患者氨基糖苷类药物治疗结果的影响。患者被随机分为对照组（根据医生选择给药；n = 75）或实验组（根据贝叶斯方案给药；n = 72）。两组在做出给药决策时均使用血清氨基糖苷类药物浓度数据。与对照组（48%；36/68）相比，实验组（60%；42/68）的反应率有所提高。对照组（7/75；9.7%）的毒性发生率高于实验组（4/72；5.1%），但差异无统计学意义。与实验组（16.0天）相比，对照组患者的总住院时间显著更长（20.3天）（p = 0.028）。多变量分析中对住院时间有显著影响的变量是患者组和氨基糖苷类药物治疗时间。基于缩短的住院时间，每位患者可实现潜在成本节省1311美元。
