Lesar T S, Rotschafer J C, Strand L M, Solem L D, Zaske D E
JAMA. 1982 Sep 10;248(10):1190-3.
Four methods for calculating gentamicin sulfate dosage requirements were evaluated in 96 patients and compared with an individualized method. The pharmacokinetic parameters of gentamicin were determined from serum concentration time data and used to calculate individualized dosage regimens. Doses were determined in each patient using the "predictive methods" (Sarubbi-Hull, Dettli, "rule of eights," and Chan). Resultant serum concentrations were calculated from doses arrived at by each method. These dosing methods resulted in a large proportion of patients with subtherapeutic or potentially toxic concentrations, or both. The Dettli and Chan methods produced therapeutic concentrations in more patients than the Sarubbi-Hull and rule of eights methods. Desired therapeutic concentrations were attained in significantly more patients with the individualized method than with the predictive methods, and, in addition, larger doses were required. The use of predictive dosage methods should be followed with serum concentration determinations and dosage adjustment to ensure therapeutic concentrations early in treatment.
在96例患者中评估了四种计算硫酸庆大霉素剂量需求的方法，并与个体化方法进行比较。根据血清浓度-时间数据确定庆大霉素的药代动力学参数，并用于计算个体化给药方案。使用“预测方法”（萨鲁比-赫尔法、德特利法、“八规则”法和陈法）确定每位患者的剂量。根据每种方法得出的剂量计算最终血清浓度。这些给药方法导致很大一部分患者的血药浓度低于治疗水平或有潜在毒性，或两者皆有。与萨鲁比-赫尔法和“八规则”法相比，德特利法和陈法在更多患者中产生了治疗浓度。与预测方法相比，个体化方法在显著更多的患者中达到了所需的治疗浓度，此外，还需要更大的剂量。使用预测剂量方法后应进行血清浓度测定和剂量调整，以确保在治疗早期达到治疗浓度。
