Independent Researcher, Santa Clara, CA, United States.
Department of Biochemistry and Molecular Biology, Monash University, Melbourne, Australia.
JMIR Mhealth Uhealth. 2020 Dec 16;8(12):e20525. doi: 10.2196/20525.
Determining a suitable dose of intravenous colistimethate is challenging because of complicated pharmacokinetics, confusing terminology, and the potential for renal toxicity. Only recently have reliable pharmacokinetic/pharmacodynamic data and dosing recommendations for intravenous colistimethate become available.
The aim of this work was to develop a clinician-friendly, easy-to-use mobile app incorporating up-to-date dosing recommendations for intravenous colistimethate in critically ill adult patients.
Swift programming language and common libraries were used for the development of an app, ColistinDose, on the iPhone operating system (iOS; Apple Inc). The compatibility among different iOS versions and mobile devices was validated. Dosing calculations were based on equations developed in our recent population pharmacokinetic study. Recommended doses generated by the app were validated by comparison against doses calculated manually using the appropriate equations.
ColistinDose provides 3 major functionalities, namely (1) calculation of a loading dose, (2) calculation of a daily dose based on the renal function of the patient (including differing types of renal replacement therapies), and (3) retrieval of historical calculation results. It is freely available at the Apple App Store for iOS (version 9 and above). Calculated doses accurately reflected doses recommended in patients with varying degrees of renal function based on the published equations. ColistinDose performs calculations on a local mobile device (iPhone or iPad) without the need for an internet connection.
With its user-friendly interface, ColistinDose provides an accurate and easy-to-use tool for clinicians to calculate dosage regimens of intravenous colistimethate in critically ill patients with varying degrees of renal function. It has significant potential to avoid the prescribing errors and patient safety issues that currently confound the clinical use of colistimethate, thereby optimizing patient treatment.
由于复杂的药代动力学、混淆的术语以及潜在的肾毒性，确定静脉注射黏菌素的合适剂量具有挑战性。直到最近，才获得了关于静脉注射黏菌素的可靠药代动力学/药效学数据和剂量推荐。
本项工作旨在开发一种易于临床医生使用的、易于使用的移动应用程序，其中纳入了危重症成年患者静脉注射黏菌素的最新剂量推荐。
使用 Swift 编程语言和常用库在 iPhone 操作系统（iOS；Apple Inc.）上开发了一个名为 ColistinDose 的应用程序。验证了不同 iOS 版本和移动设备之间的兼容性。剂量计算基于我们最近的群体药代动力学研究中开发的方程。应用程序生成的推荐剂量通过与使用适当方程手动计算的剂量进行比较来验证。
ColistinDose 提供了 3 个主要功能，分别是（1）计算负荷剂量，（2）根据患者的肾功能（包括不同类型的肾脏替代疗法）计算每日剂量，以及（3）检索历史计算结果。它在 Apple App Store 上免费提供，适用于 iOS（版本 9 及以上）。根据已发表的方程，计算出的剂量准确反映了不同肾功能患者的推荐剂量。ColistinDose 在本地移动设备（iPhone 或 iPad）上进行计算，无需联网。
ColistinDose 具有用户友好的界面，为临床医生提供了一种准确且易于使用的工具，可计算不同肾功能危重症患者静脉注射黏菌素的剂量方案。它具有避免目前困扰黏菌素临床应用的处方错误和患者安全问题的巨大潜力，从而优化患者治疗。
