Zaera Sofia, Hermida Jesus, Tutor J Carlos
Laboratorio Central, Hospital Clínico Universitario, Santiago de Compostela, Spain.
Ther Drug Monit. 2002 Dec;24(6):696-700. doi: 10.1097/00007691-200212000-00003.
The authors studied the inaccuracy effect in the determination of C(min) and C(1h) post-infusion serum concentrations of vancomycin, amikacin, and tobramycin on the recommended dose regimen (RDR) using the Abbottbase Pharmacokinetic Systems (PKS) program (Abbott; Abbott Park, IL). According to previously established criteria, the clinically acceptable error (CAE) was defined as 1/8 of the therapeutic range. For a total of 647 simulations, in most cases (94.3%) an inaccuracy of up to three times the CAE did not lead to changes in the RDR. However, and particularly for amikacin and tobramycin, in some cases an inaccuracy in the order of the CAE in C(min) lead to important differences in the RDR, which could have important consequences in clinical practice. For therapeutic monitoring of these antibiotics, it is suggested that a serum concentration from a previous moment in time, which may be determined with greater precision and accuracy, could be used instead of C(min).
作者使用雅培基础药代动力学系统（PKS）程序（雅培公司；伊利诺伊州雅培公园），研究了万古霉素、阿米卡星和妥布霉素在推荐剂量方案（RDR）下输注后血清C(min)和C(1h)浓度测定中的误差效应。根据先前确定的标准，临床可接受误差（CAE）定义为治疗范围的1/8。在总共647次模拟中，在大多数情况下（94.3%），高达三倍CAE的误差不会导致RDR的改变。然而，特别是对于阿米卡星和妥布霉素，在某些情况下，C(min)中CAE量级的误差会导致RDR出现重要差异，这在临床实践中可能会产生重要后果。对于这些抗生素的治疗监测，建议可以使用更精确和准确测定的先前时刻的血清浓度，而不是C(min)。
