Destache C J, Meyer S K, Rowley K M
Clinical Pharmacokinetic Service, AMI Saint Joseph Hospital, Omaha, Nebraska.
Ther Drug Monit. 1990 Sep;12(5):427-33. doi: 10.1097/00007691-199009000-00004.
In a prospective, randomized study, 110 adults receiving aminoglycosides were randomized to follow-up by a clinical pharmacokinetic service (CPS). Of the 110 patients, 35 accepted pharmacokinetic recommendations less than 100% of the time. The two groups were similar in age, sex, height, APACHE II score, and initial creatinine clearance. A cost-to-charge ratio was used to derive direct costs of hospitalization and calculate cost-benefit. Patients whose physicians accepted pharmacokinetic recommendations 100% of the time had shorter hospitalizations (322.67 +/- 270.28 h; CPS less than 100%, 699.54 +/- 806.35; p = 0.001) and febrile periods (50.05 +/- 79.38 h; CPS less than 100%, 120.00 +/- 153.23; p = 0.002). Acceptance of CPS recommendations led to adequate peak levels. Acceptance of CPS recommendations led to lower direct costs ($7,102.56 +/- 9,898.19; CPS less than 100%, $19,629.94 +/- 28,051.89; p less than 0.001). Calculated direct cost of the service was $85/patient.
在一项前瞻性随机研究中，110名接受氨基糖苷类药物治疗的成年人被随机分配接受临床药代动力学服务（CPS）的随访。在这110名患者中，35名患者接受药代动力学建议的时间不到100%。两组在年龄、性别、身高、急性生理学与慢性健康状况评分系统（APACHE II）得分以及初始肌酐清除率方面相似。采用成本收费比来得出住院的直接成本并计算成本效益。医生100%接受药代动力学建议的患者住院时间较短（322.67±270.28小时；CPS低于100%组为699.54±806.35小时；p = 0.001），发热期也较短（50.05±79.38小时；CPS低于100%组为120.00±153.23小时；p = 0.002）。接受CPS建议可使峰值水平达到合适状态。接受CPS建议可降低直接成本（7102.56±9898.19美元；CPS低于100%组为19629.94±28051.89美元；p＜0.001）。该服务的计算直接成本为每位患者85美元。
