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Improving IV Insulin Administration in a Community Hospital
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Comparing dose prediction software used to manage gentamicin dosing.

C Wong1, S S Kumar, G G Graham

  • 1St Vincent's Clinical School, St Vincent's Hospital and University of New South Wales, Sydney, New South Wales, Australia.

Internal Medicine Journal
|January 3, 2013
PubMed
Summary

Four gentamicin dosing programs, including TCIWorks, Aladdin, Excel, and Abbottbase, showed similar results for calculating directed gentamicin doses. These programs are suitable for clinical use in optimizing gentamicin therapy.

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Area of Science:

  • Pharmacology
  • Clinical Pharmacy
  • Pharmacokinetics

Background:

  • Australian guidelines suggest initiating directed gentamicin therapy after 48 hours.
  • Directed gentamicin dosing requires plasma concentration monitoring and dosage prediction software.
  • Existing software (TCIWorks, Aladdin) lacks comparison with established programs.

Purpose of the Study:

  • To compare directed gentamicin dosage calculations from TCIWorks, Aladdin, and an Excel-based program against the established Abbottbase program.
  • Evaluate the accuracy and consistency of different gentamicin dosing software.

Main Methods:

  • Collected gentamicin peak and trough plasma concentrations from 60-69 patients across three creatinine clearance groups.
  • Calculated the directed gentamicin dose required for a 24-hour area under the concentration-time curve (AUC) of 80 mg.h/L using four different programs.
  • Compared dose predictions from TCIWorks, Aladdin, and Excel against Abbottbase.

Main Results:

  • Strong correlations (r² > 0.97) were observed between directed doses predicted by TCIWorks, Aladdin, Excel, and Abbottbase after the first dose.
  • Mean dose ratios (compared to Abbottbase) were TCIWorks: 106%, Aladdin: 102%, and Excel: 108%.
  • Similar correlations and dose ratios were found after the second dose, with comparable results across different renal function groups.

Conclusions:

  • The four evaluated programs for calculating directed gentamicin doses produced comparable results.
  • All programs, including TCIWorks, Aladdin, and the Excel-based tool, are suitable for clinical application in optimizing gentamicin therapy.