Comparing dose prediction software used to manage gentamicin dosing.

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.