Does Accepting Pharmacokinetic Recommendations Impact Hospitalization? A Cost-Benefit Analysis

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.