A quality control analysis of aminoglycoside management
E. J. Quebbeman, T. R. Franson, J. E. Whipple, J. Bubrick, J. T. Kolesari, R. Thomson, R. K. Ausman and R. E. Condon
Aminoglycoside administration practices were evaluated in a teaching
hospital using three study methods: a chart review of 40 randomly selected
patients receiving aminoglycosides was conducted retrospectively; 93 health
care personnel involved in ordering and administering aminoglycosides to
patients were interviewed regarding their understanding of aminoglycoside
utilization practices; and ten patients having serum peak and trough
aminoglycoside determinations were closely monitored for accuracy of dose
administration and obtaining blood specimens at appropriate times. The
chart review showed that during 15 of 32 evaluable therapy courses no
determinations of serum aminoglycoside concentration were obtained. The
survey demonstrated that only 24% of the residents actually used the
results of peak and trough determinations to adjust dosage regimens. Direct
observation of health care personnel disclosed only two of ten instances in
which doses were administered and serum concentration specimens obtained
with no apparent problems. Most personnel in our hospital were unaware of
these pervasive suboptimal or inconsistent practices associated with
aminoglycoside administration and interpretation of laboratory results.