Quantitative and qualitative assessment of serum concentration monitoring and dosage adjustment of XXXX .

@entity1 @entity801 @entity5153 @entity581 @entity4028
A prospective study was carried out in 50 adult @entity1 to determine the extent and quality of @entity4028 serum concentration monitoring and dosage adjustment in a U.K. teaching hospital. Data were collected concerning prescription details, assay results, and subsequent dosage adjustment, methods of dosage determination, and timing of samples. Thirty-three @entity1 received @entity581 without a positive culture. The mean +/- SD initial doses were 1.75 +/- 0.45 mg/kg for @entity801 and 2.33 +/- 0.55 mg/kg for @entity5153 . Doses were derived from physicians' personal experience for 35 @entity1 and using nomograms for 11 @entity1 . Prescribed and actual administration times were observed on 218 occasions. The difference between these times were significantly different (p less than 0.005). Fifty-six trough, 61 peak, and 61 random assays were carried out, of which 48% of troughs and 56% of peaks were in the therapeutic range. Dosage regimens were calculated based on actual serum concentration assay results using the Sawchuk-Zaske method. These calculated doses were compared to actual prescribed doses for each @entity1 . The calculated doses were greater than 120% of the prescribed doses in 78% of @entity1 . There was a significant tendency to underdose (p = 0.001). It is concluded that the service might benefit from an individualised approach to dosage determination.
