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Updated: May 21, 2026

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Published on: June 11, 2012
Improving dosing of gentamicin in the obese patient: a 3-cycle drug chart and case note audit
Joseph G Manjaly1, Alexander M Reece-Smith, Sivan S Sivaloganathan
1CST1 , Salisbury NHS Foundation Trust , Salisbury , UK.
Objectives:
To assess the use of an electronic dose calculator to improve accuracy in the use of a complex Gentamicin prescription policy and assess turnaround time of blood sampling to dose delivery in an NHS hospital.
Design:
Retrospective review of drug chart, case notes and hospital antibiotic database.
Setting:
University Hospitals Bristol, UK PARTICIPANTS: Patients receiving once daily intravenous gentamicin using the trust protocol, during the same time window for 3 consecutive years.
Main Outcome Measures:
i) Accuracy of dose and frequency prescription of Gentamicin. ii) Time frame for measurement of serum Gentamicin levels.
Results:
Following the introduction of the online calculator, prescribing errors in obese patients dropped from 43% to 20%, a similar level as in non-obese patients. Errors in frequency calculations dropped from 12.8% to 4%. On average, drug doses could be administered within 2.5 hours of a blood sample being taken.
Conclusions:
Online tools can be used to improve prescribing for the complex dosing policies that will increasingly been required to tailor prescribing in obese patients. Serum gentamicin levels can be measured within a 2.5 hour time frame in the environment of an NHS hospital.
Related Concept Videos
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations
Drug Dosing: Obese Patients
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
Drug Dosing: Geriatric Patients
Dosage Regimen Designs: Nomograms and Tabulations
