Model for effective monitoring of patients receiving aminoglycoside antibiotic therapy

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Title Model for effective monitoring of patients receiving aminoglycoside antibiotic therapy
Publication Type thesis
School or College School of Medicine
Department Pathology
Author Gibbs, Frances Gillen
Date 1988-12
Description Monitoring a patient's serum aminoglycoside levels is essential for reaching therapeutic levels of the drug while avoiding the adverse consequence of nephrotoxicity. In 1985, aminoglycoside testing at the University of Utah Health Sciences Center was evaluated by a pharmacy resident who reported that some patients had excessive numbers of tests performed while others experienced inadequate monitoring. A committee was established to examine this perceived problem. The committee developed guidelines for aminoglycoside use which identified patients needing to be monitored and the number of levels to be performed. A new laboratory-ordering worksheet was designed to resolve specimen collection problems. Data collected on 146 patients, 71 prior to and 75 following implementation of the guidelines, were evaluated to assess the difference in the ordering patterns. In each group, PRE and POST, there were 50 patients who met the guideline criteria for being monitored. Serum creatinine levels were evaluated to assess compliance with the guidelines which recommended that they be performed every three to four days during therapy as an indicator of aminoglycoside-associated nephrotoxicity. A significant (P<.05) improvement in the ordering pattern for serum levels at 72 hours resulted after the guidelines were implemented. No change was seen in the ordering pattern of weekly serum levels. There was an 9% PRE and a 14% POST incidence of aminoglycoside-associated nephrotoxicity. The laboratory-ordering worksheets were submitted with 59% of the serum levels ordered and, when available, aided in the resolution of the problems. All hospital departments involved with aminoglycoside therapy had influence and control over the final solutions which aided in their acceptance of changes.
Type Text
Publisher University of Utah
Subject Laboratories; Monitoring; Physiologic; Antibiotics; Aminoglycoside
Subject MESH Aminoglycosides; Antibodies; Dose-Response Relationship, Drug; Drug Utilization; Kidney Diseases
Dissertation Institution University of Utah
Dissertation Name MS
Language eng
Relation is Version of Digital reproduction of "A Model for effective monitoring of patients receiving aminoglycoside antibiotic therapy". Spencer S. Eccles Health Sciences Library. Print version of "A Model for effective monitoring of patients receiving aminoglycoside antibiotic therapy" available at J. Willard Marriott Library Special Collections, QP6.5 1988 .G52.
Rights Management © Frances Gillen Gibbs.
Format application/pdf
Format Medium application/pdf
Format Extent 987,869 bytes
Identifier undthes,4501
Source Original: University of Utah Spencer S. Eccles Health Sciences Library (no longer available).
Master File Extent 987,966 bytes
ARK ark:/87278/s6ft8ns1
Setname ir_etd
ID 190494
Reference URL https://collections.lib.utah.edu/ark:/87278/s6ft8ns1
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