UNASSIGNED: This study aimed to evaluate the appropriateness of gentamicin therapeutic drug monitoring (TDM) at a tertiary care hospital in Qatar.
UNASSIGNED: A one-year quantitative retrospective chart review of all gentamicin TDM records was conducted. Evidence-based criteria were applied to evaluate the appropriateness of gentamicin TDM in terms of indication, sampling times, and post-analytical actions.
UNASSIGNED: Out of 59 captured gentamicin TDM records, 58 gentamicin samples were eligible for evaluation. Overall, gentamicin TDM appropriateness was achieved in 50% (n = 29) of the evaluated records. However, 12% (n = 7) of gentamicin drug concentrations were below the assay quantification limits or were not sampled appropriately. Inappropriate post-analytical actions (22.4%, n = 13) and inappropriate sampling times (44.8%, n = 26) were recorded. Most of the gentamicin blood samples (n = 43; 74.2%) were taken appropriately at steady-state. Inappropriate sampling time relative to the last dose was captured in 31% (n = 18) of the cases. Although 27.6% (n = 16) of gentamicin concentrations were non-therapeutic, continuing gentamicin dosing without adjustment was the most frequent post-analytical action (69.8%, n = 37). Gentamicin dose regimen continuations, dose regimen decreases and dose regimen discontinuations were inappropriately applied in 27% (n = 10), 25% (n = 2) and 14% (n = 1) of the times, respectively.
UNASSIGNED: Suboptimal gentamicin TDM practices exist in relation to sampling time and post-analytical actions. Studies exploring setting-specific reasons behind inappropriate TDM practices and methods of its optimisation are needed.
■本研究旨在评估庆大霉素治疗药物监测(TDM)在卡塔尔一家三级保健医院的适当性。
■对所有庆大霉素TDM记录进行了为期一年的定量回顾性图表审查。采用循证标准评估庆大霉素TDM在适应症方面的适当性。采样次数,和分析后的行动。
■在59条捕获的庆大霉素TDM记录中,58个庆大霉素样品符合评估条件。总的来说,在50%(n=29)的评估记录中实现了庆大霉素TDM适当性。然而,12%(n=7)的庆大霉素药物浓度低于测定定量限或未适当取样。不适当的分析后行动(22.4%,n=13)和不适当的采样时间(44.8%,记录n=26)。大多数庆大霉素血样(n=43;74.2%)是在稳态下适当采集的。在31%(n=18)的病例中捕获了相对于最后剂量的不适当的采样时间。虽然27.6%(n=16)的庆大霉素浓度是非治疗性的,继续给予庆大霉素而不调整是最常见的分析后行动(69.8%,n=37)。庆大霉素剂量方案延续,剂量方案减少和剂量方案终止不适当地应用于27%(n=10),25%(n=2)和14%(n=1)的次数,分别。
■庆大霉素TDM实践与采样时间和分析后行动有关。需要研究探索不适当的TDM实践背后的特定设置原因及其优化方法。