- Title
- Development of a therapeutic drug monitoring model for aminoglycosides at a private hospital in the Eastern Cape
- Creator
- Swanepoel, Caro Mae
- Subject
- Aminoglycosides -- Eastern Cape
- Subject
- Nephrotoxicity -- Eastern Cape
- Subject
- Drug Monitoring
- Date Issued
- 2022-12
- Date
- 2022-12
- Type
- Master's theses
- Type
- text
- Identifier
- http://hdl.handle.net/10948/60276
- Identifier
- vital:64291
- Description
- Background: Aminoglycosides are highly effective against Gram-negative bacteria, including ESKAPE pathogens. However, aminoglycosides can cause nephrotoxicity and ototoxicity. Therapeutic drug monitoring (TDM) performed in patients receiving aminoglycosides can potentially reduce the development of antimicrobial resistance as well as aminoglycoside-induced toxicity and side effects. Primary Aim: The study aimed to identify TDM practices and subsequently develop a model for aminoglycoside TDM at a private hospital in the Eastern Cape. Methodology: Phase One involved the collection of data from the hospital’s database, using a purpose-designed data collection tool. Data from 135 eligible patients who received aminoglycoside therapy from June 2019 to June 2020 were reviewed. Data was captured, coded and analysed (using differential analysis). Semi-structured interviews were conducted (Phase Two) with three physicians and five pharmacists. Interview transcripts were coded using a combination of inductive and deductive coding techniques, followed by thematic analysis. The data was triangulated and used, together with recommendations from similar guidelines, to design a context-specific model for aminoglycoside TDM at the hospital. Results and Discussion: Results from Phases One and Two showed that TDM was not being performed correctly at the hospital. The overall incidence of aminoglycoside TDM was 19.26% (N = 135). The highest incidence of TDM occurred in ICU patients (n = 31; 51.61%). Drug monitoring was not consistently conducted in elderly (≥65 years) patients, or in those with signs of renal impairment; even though interviewed physicians and pharmacists identified elderly and renally impaired patients as “high risk” patients. Challenges regarding implementation of aminoglycoside TDM were explored. A lack of competent staff and time constraints were identified as major barriers to quality TDM services. Conclusion: The daily practices and TDM challenges at the site were considered during the design of the aminoglycoside TDM model, which can potentially facilitate better execution and monitoring practices for aminoglycosides at the private hospital.
- Description
- Thesis (MA) -- Faculty of Health Sciences 2022
- Format
- computer
- Format
- online resource
- Format
- application/pdf
- Format
- 1 online resource (xiv, 353 pages)
- Format
- Publisher
- Nelson Mandela University
- Publisher
- Faculty of Health Sciences
- Language
- English
- Rights
- Nelson Mandela University
- Rights
- All Rights Reserved
- Rights
- Open Access
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NMU School of Medicinal Sciences
| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | SOURCE1 | Swanepoel,C Dec 2022.pdf | 7 MB | Adobe Acrobat PDF | View Details Download |