Improving aminoglycoside dosing through computerized clinical decision support and pharmacy therapeutic monitoring systems

Dosing errors and inadequate laboratory monitoring of aminoglycosides may lead to significant adverse drug events. Correctly prescribing aminoglycosides requires familiarity with multiple mathematically complicated dosing and laboratory monitoring protocols. We developed a clinical decision support system for ordering aminoglycosides which is integrated into a computerized provider order entry system. To complement the ordering tool, we implemented a real-time tracking application to allow the pharmacist-staffed therapeutic drug monitoring service to follow patients prescribed aminoglycosides.