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Predictive performance of gentamicin dosing nomograms.

Jieon Lee1, Seonghae Yoon1, Donghoon Shin1

  • 1Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea.

Drug Design, Development and Therapy
|August 26, 2014
PubMed
Summary
This summary is machine-generated.

Existing gentamicin dosing nomograms poorly predict peak serum concentrations in Korean patients. New nomograms, especially for once-daily dosing in infective endocarditis, are needed, alongside therapeutic drug monitoring.

Keywords:
Bayesian methodantibioticsinfectious endocarditistherapeutic drug monitoring

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Area of Science:

  • Pharmacology
  • Clinical Pharmacy
  • Infectious Diseases

Background:

  • Gentamicin dosing nomograms are used to guide initial regimens.
  • Their predictive performance varies and requires evaluation in diverse patient populations.
  • This study focuses on Korean patients, including those with infective endocarditis (IE).

Purpose of the Study:

  • To assess the predictive performance of established gentamicin dosing nomograms.
  • To compare the accuracy of multiple daily versus extended-interval dosing nomograms.
  • To evaluate nomogram efficacy in Korean patients with IE and other infections.

Main Methods:

  • Pharmacokinetic parameters were estimated using Bayesian analysis in 84 IE patients and 95 other infection patients.
  • Six nomograms for multiple daily dosing and extended-interval dosing were evaluated.
  • Synergistic combination dosing nomograms were assessed in IE patients.

Main Results:

  • Nomograms demonstrated poor performance in achieving target peak gentamicin concentrations.
  • Multiple daily dosing nomograms were more accurate than extended-interval dosing nomograms.
  • Once-daily dosing was less effective than thrice-daily dosing in IE patients for achieving target peaks.

Conclusions:

  • Current gentamicin nomograms are inadequate for achieving target peak serum concentrations.
  • Development of new nomograms, particularly for once-daily dosing in IE, is warranted.
  • Therapeutic drug monitoring is crucial for optimizing gentamicin therapy and ensuring efficacy.