Establishing an aminoglycoside pharmacokinetic monitoring service in a community hospital.

A pharmacy-based aminoglycoside pharmacokinetic monitoring service is described, including the use of serum gentamicin levels before and after the service. A retrospective drug and serum level use review for i.v. gentamicin treatment of 80 patients during an 11-month period was conducted. It established a need for a pharmacokinetic monitoring service, which was first instituted as a six-month pilot program. Twenty patients in the retrospective review had 43 serum levels obtained for an average of 2.2 levels per patient. In comparison, 39 patients in the pilot program had 243 serum levels drawn for an average of 6.2 levels per patient. Only six (14%) of the serum levels were obtained correctly and used appropriately in the review, compared with 231 (95%) in the pilot program (p less than 0.0001). It is concluded that the method used in establishing this service is a satisfactory approach for pharmacists who wish to convince administrators and medical staff of the need for pharmacokinetic consultation.