Mississippi Mud No More: Cost-Effectiveness of Pharmacokinetic Dosage Adjustment of Vancomycin to Prevent Nephrotoxicity

William Darko, Pharm.D., Joseph J. Medicis, Pharm.D., Adrienne Smith, Pharm.D., Roy Guharoy, Pharm.D., David F. Lehmann, M.D., Pharm.D.


Pharmacotherapy. 2003;23(5) 

In This Article


Evaluation by decision analysis over a range of assumptions, varying probabilities, and costs reveals that pharmacokinetic dosage adjustment of vancomycin to prevent nephrotoxicity is not cost-effective for all patients. However, such dosage adjustment demonstrates cost-effectiveness for patients receiving concomitant nephrotoxins, intensive care patients, and probably oncology patients. Further studies might consider an analysis of efficacy enhancement through pharmacokinetic dosage adjustment. Combined with our study, such an analysis would provide conclusive evidence regarding when to apply pharmacokinetic dosage adjustment to make vancomycin therapy as effective as possible.