Two nomograms for determining extended-dosing intervals for gentamicin in neonates.

PURPOSE: The development of two nomograms to predict dosing intervals for gentamicin in neonates based on one gentamicin concentration is described. METHODS: Pooled data from three retrospective studies on neonates age seven days or younger were used to create nomograms that would predict dosing int...

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Publicado en:American Journal of Health-System Pharmacy Vol. 65; no. 7; pp. 624 - 631
Autores principales: Murphy JE, Roether AM
Formato: research Journal Article
Publicado: Oxford University Press / USA 4/1/2008
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 4/1/2008
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      pub: Oxford University Press / USA
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        atl: Two nomograms for determining extended-dosing intervals for gentamicin in neonates.
      aug:
        au:
          Murphy JE
          Roether AM
        affil: College of Pharmacy, University of Arizona, Tucson, AZ 85721-0202, USA. murphy@pharmacy.arizona.edu <murphy@pharmacy.arizona.edu>
      sug:
        subj:
          Antibiotics Administration and Dosage
          Antibiotics Blood
          Gentamicins Administration and Dosage
          Gentamicins Blood
          Antibiotics Pharmacokinetics
          Dosage Forms
          Dose-Response Relationship, Drug
          Drug Administration Schedule
          Gentamicins Pharmacokinetics
          Infant, Newborn
          Models, Statistical
          Time
          Human
          Infant, Newborn: birth-1 month
      ab: PURPOSE: The development of two nomograms to predict dosing intervals for gentamicin in neonates based on one gentamicin concentration is described. METHODS: Pooled data from three retrospective studies on neonates age seven days or younger were used to create nomograms that would predict dosing intervals for gentamicin. The population volume of distribution (0.45 L/kg) and a determined half-life were used to create nomogram cutoff concentrations that could select a dosing interval for neonates to achieve steady-state trough concentrations of < or =0.5 or < or =1 mg/L. A dose of 4 mg/kg was used to simulate concentration-versus-time profiles for included neonates based on their individual pharmacokinetic data. Predicted concentrations from hours 6 to 22, at one-hour intervals, for each neonate were compared against the nomograms and evaluated for the number of correct interval predictions. The nomograms were considered to have failed at any time point where they indicated an interval that would not have achieved the desired trough concentration of < or =0.5 or < or =1 mg/L or if the interval chosen was longer than necessary. RESULTS: The 0.5- and 1-mg/L nomograms predicted correct dosing intervals for 81-92% of neonates for postinfusion hours between 15 to 21 and 86-93% for postinfusion hours of 13 and 21, respectively. Accuracy of the nomograms to predict correct dosing intervals improved as the postinfusion time before the next concentration measurement increased. CONCLUSION: Using the two nomograms may help predict the correct extended-dosing intervals of gentamicin administration for neonates. Prospective evaluation and validation of the nomograms may be necessary for their wider use as a clinical tool.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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