Analog computer monitoring and evaluation of a dosing nomogram for gentamicin based on the c'min-method: Part I

Present methods for dosing gentamicin are based on usual doses or desired peak concentrations. The effective range is believed to be between 3 and 10 micrograms/ml. A method is proposed to maintain the minimum steady state concentration at a desired MIC with peak concentrations not exceeding 10 microgram/ml. After determination of the log serum creatinine-log creatinine clearance relationship in a specific population group (Peruvian mestizos), a nomogram for dosing gentamicin was developed. The applicability of the nomogram or the corresponding equation upon which the nomogram was based was tested in patients for desired MIC of 0.5, 1.0, 1.5 and 2.0 microgram/ml, and the actual c'min values obtained were compared with predicted levels. Using a correction factor, the nomogram is applicable for the United State and European population. The importance of drug level monitoring is emphasized.