Individualized dosing has been shown to have such a significant effect on patient outcomes that it is recommended by the Australian Therapeutic Guidelines, and is supported by a Cochrane Review showing both increased therapeutic effect and decreased side effects.
The following papers are split into three sections: improved outcomes, reduced adverse events, and reduced costs.
Improved Outcomes
The following papers are just some of the randomized controlled clinical trials that show the patient benefits of dose-individualization:
- Increased survival for childhood leukemia patients.
- Improved survival for septic patients.
- Increased patients in therapeutic range (chemotherapy).
- Increased proportion of patients in therapeutic range:
- Decreased time to therapeutic stabilization.
- Shortened febrile periods:
Reduced Adverse Events
Dose-individualization reduces adverse events. The following RCTs demonstrate some of these benefits:
Reduced Costs
Improving patient outcomes and reducing adverse events is highly cost-effective. The studies below quantify the cost-benefits of individualized dosing:
“[Aminoglycoside Bayesian dose individualization] is a well-accepted practice… [Further studies] may not be feasible for ethical reasons.” – Ho et al.
Bayesian dosing has been shown to have such significant benefits that some leading researchers believe that further clinical trials may be unethical, due to the control arm being required to receive substandard treatment.