Departments of Pharmacology and Medicine, University of Manchester, Oxford Road, Manchester.
Br J Clin Pharmacol. 1974 Feb;1(1):45-50. doi: 10.1111/j.1365-2125.1974.tb00205.x.
1 A nomogram and a digital computer program have been developed to calculate dosage schedules of gentamicin for individual patients. The minimum input data consist of the patients' age, sex, body weight and serum creatinine concentration. 2 These prescribing aids have been evaluated in 36 patients with severe Gram negative infections. Renal function ranged from normal to complete anuria. Nomogram dosage schedules gave serum concentrations of gentamicin within the chosen therapeutic limits. Physician dosage schedules gave serum concentrations which sometimes exceeded and sometimes fell below these limits. The validity of the computer program was demonstrated by its ability to predict serum concentrations of gentamicin whatever the dosage schedule. 3 Half the patients recovered from the bacterial infection but seven remained infected and eleven died. Pseudomonas aeruginosa was the most difficult organism to eradicate. 4 Four of the patients who survived developed ataxia and two developed hearing loss at high frequencies. The risk of ototoxicity was a function of mean trough serum gentamicin concentration and duration of treatment. Ototoxicity was only detected in patients with serum creatinine concentrations above 3 mg/100 ml who tended to have higher trough concentrations. When treatment was prolonged beyond 8-10 days the risk of ototoxicity was increased without evidence of further substantial therapeutic benefit.
已经开发出一种列线图和一个数字计算机程序来为个体患者计算庆大霉素的剂量方案。最小的输入数据包括患者的年龄、性别、体重和血清肌酐浓度。
在 36 例严重革兰氏阴性感染患者中对这些处方辅助工具进行了评估。肾功能从正常到完全无尿不等。列线图剂量方案使庆大霉素的血清浓度在所选治疗范围内。医师剂量方案使血清浓度有时超过，有时低于这些范围。计算机程序的有效性通过其能够预测庆大霉素的血清浓度来证明，无论剂量方案如何。
一半的患者从细菌感染中恢复，但仍有 7 人感染，11 人死亡。铜绿假单胞菌是最难消除的生物体。
在幸存的患者中，有 4 人出现共济失调，2 人出现高频听力损失。耳毒性的风险是平均谷浓度和治疗时间的函数。只有血清肌酐浓度超过 3mg/100ml 的患者才会出现耳毒性，他们往往有更高的谷浓度。当治疗延长至 8-10 天以上时，即使没有进一步的实质性治疗获益，耳毒性的风险也会增加。
